DRIVEWAY/ SLAB PERMITApplication is hereby evade for the approval of the detailed statement of the plans and specifications herewith submitted for ehe b:iid•-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of ^iarn7
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all roles and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specifi or not. A copy of aopra;v
plans and specifications must be kept at building during during p�grese of the work.
L
Owner's Name and Address . /L /�' 4/64 _ No
Registered Architect and /or Engineer...7T.
Name and address of licensed contractor (
peared
therein by him stated are true.
Permit No _
Disapproved Date._
(Signed) � /' u. c Ihspcctor
MI S H II RES VILLAGE
UlLDONG ONSPECTOON DEPARTMENT
AFPU 11I N FO
Date
a
Cam)
UALDINE PE rr
Ake-C ;5.
4 % S svre_ 9 /
Location and legal description of lot to be built on /
Lot 22 Block 2- - Subdivision //�3�/l / s S o `Y ' S SEC_ • 2
Street and Number where work is to be done 4" 9 e
State work to be done and purpose of building (by floors) ' !•) C--S1- ( f .. —
G C V — FO e r:a.er et' rAt c_e
_.._. Qed :TOY no othsrr uspeee.
New Building Remodeling Addition Repairs No. off S4oriea
To be constructed of oz. vf�! • Find of foundation Reef Covering ..-_
Estimated Total cost of improvements 6 /3-0 0 Amount of Permit e. /
Zone cubage required .Plan Cubage
Distance to next nearest building.... /Q• '/- - Size Size of Building Lot / 2 /7 y s
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 bu'Iding and its constructier may
be sent to .f i'41------/ L A'/'° / . 7-5 (i/4 9� 7 .
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor 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 employes 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 rulrlic notice
or notices as are required by the Act. The undersigned agrees to employ only such su tractaas, �o wars to b= rforrneo, -order trus
perrnit, as are licensed by Miami Shores Village. r� ' ... —/ —. /
Remarks._._ ( Signed )Xi
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persot ;ally rp-
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 f egoing application, and that he did sign the prat.:, and that all frees
Read, Sworn to and Subscribed before OW.
Notary Public, State of Florida
My Commissioae Ettpires
L .._r .! , 0..
F3NN / 'k- °.
to me well !mo
PLANNING BOARD .._ DATE
Chairman 1 Member
Member Member
Member .. .. - . - --._ Member .--. - -. - .- --
Council Approved Date Disopprc 'd.. ........ /Dal¢
NOTE: A charge of $1.00 will be made for making corrections oe changes to this application nfter approval hes laee.e. csbla €rt l !axe.
the Planning Board.
A re- in.pcc•tion fee of X1.00 will be charged wiaem aueh ao- iwspeeelen ea rnede necessary fop impropea notirn Gar Ts ai , 6Le@ty
materials and /or workmanship.
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LOCZ1TIOU
3LE:ial OF 51Jevg.
OF-
LOT22-LOCL
3 UCl2ES: 3EC.
01-7.1,4/41-41 si4o2Ec-6,--Ft4,
According to Plat Book 1
PUI,slic Records of Dade County, na,..
CERTIFICATION: I Hereby Certify that .
the Survey of the properly described. * •
hereon it; Irtie.1 ood corrt:c1 to the
rnv
td;der my direction
a th,:t inere dr.? no encroachments
unless shown (J( Outer j
ce /
Reg. Surveyor No. 494 State of Florida °
:Epr. 7 DONALD W. MrINTOSIi & ASSOCIATES
, If •
/ /
Owner's Name and Address
MIAMI SHORES VILLAGE
UILDING INSPECTION DEPARTMENT
APPLICATION FOR = LIILDING PERMIT
Application is hereby made for tlic approval of the detailed statement us in plans and specifications herewith submitted for the build
ing or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be ept at building during progress of the work.
edi
Registered Architect and /or I nsineer
Name and address of licensed contractor _.—
Location and legal description of lot to be built on:
Lot Block.
Date..._..._ 19 /;$
.. ._ No. /Street--
III. < a••R, »RVN ^t
Street and Number where work is to be done g .a .. State work to be done and purpose of building (by floors) -.._ _..._� &Z'
Building Inspector
Subdivisio
Chairman
MIcrrbcr
Micmber .. _.-- -•- -- ...._..._._ ...._....._
Council Approved Date
PLANNING BOARD DATE
Member
Member
Member
Disapproved
Date k?414 Read, Sworn to and Subscribed before me.
Date.. _........_
Notary Public, State of Florida
My Commission Expires
ns or changes to this application after approval
NOTE: A charge of $1.00 will be made for making correctio
the Planning Huard.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice
materials and /or workmanship.
and for no other purgasr.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements S V
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 employee
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied %kith the revisions 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 ins ection on the site of the wor such hlic notice
or notices as are required by the Act. The undersigned agrees to employ only such su • tractors, on worij/ pEr'forfne this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. d ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to wee well lsmowrn
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 flea
therein by him stated are true.
Permit No.._..!. fig
Disapproved ..
(Signed)
Date
has been ob9aireedl francs
for inspection ese (faulty
v
t (
-4
Sca
Litfa
■211.10101.
~� ~�_ ---.
THESE PLANS ARE API FOR ISSUANCE OF A BUILDING PE['i.I.
❑ WITH NO VARIANC :S [I WITH VARIANCE(S) LISTED IN "REMARKS"
NO OTHER DEVIATIONS 7,10M THE MIAMI SHORES BUILDING AND ZD'" , :"
ORDINANCES WILL I r PEin:IIf ED, UNLESS SPECIFICALLY LISTED 3E'
ALL OTHER APPLICABL'c STA:E. AND COUNTY LAV S MUST 3E C0i.1P .IEIJ
WITH BY ALL PA„TIES.
FIRE DEPARTMENT
PU3LIC WORKS
POLICE DEPARTIVIEN i L
BUILDING DIRECTOR
PLANNING & ZONING IlDARD
VILLAGE COUNCIL
PRELIMINARY:
REMARKS:
Authori %ed S Cn -ture D
/APPROVAL
COMPLIANCE WITH TEE SOU ?'. -I FLORIDA BUILN G CODE AS F,C'?PT D
BY MIAi;iI SHORES VILAAGE !S REQUIRED. TVE ARCHITECT, 3UILDf -`
SUB CONTRACTORS AR!: r''`.!'..7 'T • ' ;( '0:''! ErnE r'r 1,11 J. 1
!NG REGULATIONS WH! :19E1 OR NOT SPECIFICALLY INDICATED HEFr:iN. 1