830 NE 91 Terr (4)Permit No
Disapproved
(Signed)
Member
To be constructed of 0'6 w - Kind of
Estimated Total cost of improvements $
Zone cubage required
Distance to next nearest building _.. 7/�
D
uilding Inspector
AM 6 S H O f LSD B AFT lO LA G E
BUILDING INSPECTION DEPARTMENT
AF LOCATION FOR Li 0 G PERM OT
Application is hereby made 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 , 19
Owner's Name and Address ... ✓ 4Ci _. - Z- ... No._. g S:a Street../L!_ r T✓�(L
Registered Architect and /or Engineer Lc), L
Name and address of licensed contractor ...O.lr..l5_
Location and legal description of lot to be built on:
Lot< - _ ./OC.L. ci _._ Block S Subdivision /JtI' ✓ _ _
Street and Number where work is to be done 3 ) q, 7 T --∎Z •
State work to be done and purpose of building (by floors)....___
New Building Remodeling _..____...._. _.. __ Addition._
"PcaoC - r _...
and for no other purpose.
Repairs No. of Stories
foundation (2 OZ- . Roof Covering
Z S" o _ °S7 Amount of Permit $
_Plan Cubage T• ` i 2 - E �-
C SST = o
Size of Building Lot '75 x /"SCI
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 k a Pc, C € - Sv - x rr� Sr, s-, d tea- e•-•1 t
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 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed )77 4,/C •
STATE OF FLORIDA,
COUNTY OF DADE. J ss
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
1 Date___ /4'•
._!6 '� Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman . y Member
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 Planning Board.
A re- inspection 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.
Date S - 22-7/
WORK DESCRIPTION
rt. 464
Job Address
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Tax Folio // JA SJfmk91
Legal Description 9-4- e i � y1/ /� � 'i Master Permit #
Owner / -{ - T_ - , a /i / `/UT a
Signature of Owner and /or Condo President
'ate:
iotary as to Owner and /or Condo President
ly Commission Expires:
r . * . * * * *
'ERMIT FEE: APPROVED:
�3.3o rvF.
Owner's Address
Contracting Co. ������U Address
Qualifier SS# - - Phone
State° Competency# Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIM.
NEW CoNC VR /V/ 14/4 Y 5- P / //V
Square Ft. Estimated Cost 1,66o,
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO
DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work.
AMER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work
gill be done in compliance with all applicable laws regulating construction and zoning.
Furthermore, I authorize the above -named contractor to do the work stated.
Fire
Zoning Building 1 /
Mechanical Plumbing
Signa' ure of or Own =r- Builder
Dat e:
.4 4
My Commission Expires: 1/
/ /
N�t ary' as to Contractor o er- Builder
* * * * *
Other
Phone 7 5 8 " 5 7r?
Electrical
Engineering
*
*
75
/
3
•
C 44÷4Trt
:A LL \ \RKJ t
3. 0-4 m s\
-4 \t"■ *4 _
1
»�_4o �Lks'
V \
� +6
�� /
THESE PLANS hilE APP::Jk.'Et; .s,.:Z
:::...i, i..):: .; OUILDING PERMIT
I: i ''APP, • :-.!') USTED IN "REMARKS"
. • ' - 7 • T.::! ::-Mr; A ZONING
: .. . ;:':...:.!. LI'..TED BELOW.
P.. ... . :' L.'.'.'S :".11;!::1 2E COMPLIED
- • - ." turf; Dr tt
• WITH -.:0 V: - !!'::', 7 - I .
NO OTHER nE !'T'r, ::.; .'
.CED! •:..ii.!.. LE P: . :1. f :
LL OT 'E VT IC: I :-: .•, ..ti-
-:ITH BY Ik!_t PA:;:iES.
'IRE DEP. :1- • ..-
ri'..): I;*7 nr.?•:...:•. :
PLAN'.:1.1C -& Z: .• .1 1:-... .
;.—.--
, VILLAGE COU,:::!:
APPROVAL
PRELIIVilrIARY:
REMARKS:
COMPLIX:CE W!Tli T:-:E :-.:.:Jr;; :--.; r.'..;i0 :...:! :) .i ..:0".•)E. , f D:TTED
BY MIAMI SHORES 'ILL GE :::'. P.r.i.::;..1::::"'J. i E .•,i;c;:ili•E'...I, 3U DER &
SUB CONTRACT23 , .:1 • • . . .0... r:-.( 1.7
ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN.