1967 CHAIN LINK FENCEBUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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.
Owner's Name and Address
MIAMI SHORES VILLAGE
Registered Architect and/or Engineer... . __
Name and address of licensed contractor_ 1 C
Location and and le description of lot to be built on:
Lot_ Block Subdivision t foerz. S 6 C
Street and Number where work is to be done -5 g
State work to be done and purpose of building (by floors)__ 4/ /7/`,/..<9 L
Ref.
and for no other purpose.
New Building_ '' Remodeling Addition Repairs. No. of Stories
To be constructed of Kind of foundation_ Roof Covering_
Estimated Total cost of improvements $ 2 - X 1 ° 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 foi said building. All notices with reference to the building and its construction may
be sent to__ _
The undersigned applicant for this building permit doc hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen s Compensation Act, being Sec:ion 5966, Compiled General Laws of Florida, Pennanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him
i the work to be performed under this permit; and will post or cause to be posted for i.pection o t
or notices as are required by the Act. The undersigned agrees to employ only such
permit, as are licensed by Miami Shores Village.
Remarks _ (Signed) 4 c-".0." f rk n h
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, 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.
Permit No........ Date_ 6 -7
Disapproved ____
(Signed ) s ector
Chairman
Member
Member .
Council Approved
Date /1 6
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires_
PLANNING BOARD. DATE
Member
Member
Member
_Date Disapproved
, 19 47
No. 519 ° Street_ 9 0
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 51.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.
r T
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
Date — - f' 1917
ELECTRICAL ❑
PLUMBING ❑ PERMIT N? 9356 Contractor's
ROOFING ❑ License No. 3 2
•
Owner of
Building
Architect
Contractor
or Builder
4 C /�
Legal Lot /�
Description +'
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with and
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder name above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the fans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants qr employes.
C J
Signed ! 3 �� --�?'� ZI NSPECTOR) BY
In consideration of the issuance to me of this permit I a e to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining there and in strict conformity with the plans, draw , statements or specifications submitted to the proper authorities of Miami Shores Village.
In acceptini thif perr1iit I assume responsibility for all work o e by either, myself, my agent, servant or employee.
CONTRACTOR or BUILDER
Work to be performed under this Permit
II 131
7 14)
/ fro
Subdi-
vision 1,, C. - /JO,. c 7t c cr__ei. 4L
Sq Ft 6 Value of ZS1!" 11 Amount of c
Project $ 7 11 Permit $
BY AUTHORITY