830 NE 91 TerrPermit No
Application is hereby wade for the approval of the detailed statement of the plans and specifications herewith submitted for the build -
ing 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.
Date..._ _.. VC,._ ,19
Ou-ner's Name and Address ... . ���'T ........ No ` Str
: , w eetJKF' f1 ir44C c'
.. .................
Registered Architect and /or Engineer
Name and address of licensed contrpctor
L (B s AVAll% 6Pie . . , 4z ss #
Location and legal A
description of lot to be built on: p
Lot �` J 1# 6f Block Block 3 Subdivision. .. t e 0 F%�...t )`Le' l A:t'r i4 4)7/6
Street and Number where work is to be done 'Y` J2': ...�
State work to be done and purpose of building (by floors)._. Ye,v 0 / 4 7 FA' _ A.A?!r - ®f+' v 6 .._
and for no other purpose.
New Building Remodeling ,X.. Addition Repairs No. of Stories _
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $.. ' Amount of Permit $.
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.
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 Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint
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 subcontractors, on work to performed under this
permit, as are licensed by Miami Shores Village. 4
Disapproved
(Signed)
Remarks
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
______ - to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Date
Chairman
Member
Member .. _ .
(Signed).
Date.- .....o
> - Notary Public, State of Florida
Building spector tea! My Commission Expires
PLAN2G BOARD DATE
Read, Sworn to and Subscribed before me.
Member
Member
Member .._._
Council Approved Date Disapproved Date
NOTE: A ch.uge of $1.00 will be made for making corrections or changes to this application after approval has hem obtained from
the Planning Board.
A re fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
N.47
$ 13
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9245 S.W. 44th Street LAND SURVEYOR Telephone:
SURVEY NUMBER 76 -2 -31 MIAMI. FLORIDA 221- 3416
W
SURVi3'Y OF
LOT The West 1/2 of lot 8 and all of lot 9 BLOCII 3
SUBDIVISION GOLDEN GATE PARK ADDITION
According to the Plat Thereof as Recorded ht Plat Book No 6 At Page No 130
Public Records of Dade County, Florida
Date: April 27th, 1976 For Consolidated Builders Inc.
Location Sketch:
)3 0 A/ 6 ?7 7ZiM)/ics• Avt7 Res
N. .
Scale - 2O
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LOCATED IN:
MIAMI SHORES,
DADE COUNTY, FLORIDA.
7
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CHARLES W. CARR
Scale: 1" - 1 5 0
440
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78.66
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I HEREBY CERTIFY that the attached
sketch represents a recent survey made
under my direction, and is true and cor-
rect to the best of my knowledge and
belief. There are no encroachments.
E x A!!o[
STATE OP FLORIDA
REGISTERED LAND SURVEYOR 1060
20' PQ t,'7`
Pipe