815 NE 91 Terr (2)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby uinde for the approval of the detailed statement nt us toe plans and specifications herewith submitted for the build
inc or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address Bandola
Date..._..._..._._...w r_.__. Jag.: 19th 19.. 9 0
_ No 8 15 _.. StreetN • E. 91 T e r r.
Registered Architect and /or Engineer.. ... •11..11,,.,......•....,
Name and address of licensed contractor
Location and legal description of lot to be built on: ,�/ / � � ;�
Lot.. /7Y - 16, /6 Block 1 Subdivision �"'u"' . _ lhedl / l _._5rlo6 6 G r0 "
Street and Number where work is to be done 815 N . E . 91 Terrace
State work to be done and purpose of building (by floors)... 1. c.i. Z. Qt... ESLt .z.e...Wi.t.h...1. 1a..y.P.. .._o.f 4.3 .fe.1.tL_
_..._ .............. 2.- .1.a.ye.iss... #....f.elt.. .n.d...g.raue.l.. °I
and for no other purpose.
Ncw Building Remodeling X ......... Addition Repairs No. of Stories 1
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 4, 885 . 00 Amount of Permit & Q....
Zone cubage required _...Plan Cubage
Distance .to next nearest building.. Size of Building Lot _........_
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to.. Tomco Roofing- 1 395._.. Ins.......1. 0. 7.... Ave. .... H. i.. a. 1... ....G.a.z.d.,.F1.......3.3.0.1.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup dement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontr ors, work to be performed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks J. P. C r a i g
Building Inspector
Tomco RoofingPJC INC. 13395 N.W. 107 Ave. Hial.Gard
(Signed )1111 s
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
__. to ode well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the. Roofing Contractor
of the above described construction, that he has carefully read the foregoing application, and that he did sign the tame, 4nd,that !ll facts
therein by him stated are true. ) f
Permit No.._.._- #5 ` u Date ) 1 ) " / C7D Read, S o and Sub before me.
•
._ ��
Disapproved � ate. y . � / .
�
Not //.'' l ic, State,) Florida
(Signed) My Commission Expires. - NO' ARY PUBLIC, STATE OF FLORIDA.
h 9YZIRVIrfSgfORriTifiErliarf T77 T .
BONDED THRU NOTARY PUBLIC UNOERWRITSR9:
PLANNING BOARD DATE
Chairman Member
\Icrnber Member
Member .. Member .._._ _.._.....
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Plannir,;; hoard.
A re impaction fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.