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DRIVEWAY PERMIT
APPLICATION FOR BUILDING PERMIT 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. State work to be done and purpose of building by floors) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT C .�.N .. .. .. ... _.._... 19 2- No. 11.� Owner's Name and Address . Registered Architect and /or Engineer Name and address of licensed contractor... Location and legal description of lot to be (ill on: Lot Block Subdivision Street and Number where work is to be done ... .t t! T••! ,2••Tt!!T"••tT!•••STStttll�M..... 112 and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundatio n ib Roof Covering Estimated Total cost of improvements $ _.�Q..n Amount of Permit Zone cubage required _ ...._.......plan Cubage Distance to next nearest building Size of Building Lot Mfaxirnum 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 budding 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 • . actors, on w to be performed under this pennit, as are licensed by Miami Shores Village. Remarks (Signed 1 • _Z STATE OF FLORIDA, COUNTY OF DADE. J Ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persortally ap- peared 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 are true. / . ,---- Permit No..__ t 7 / 7 Date ` (` / . _ - Read, Sworn to and Subscribed before me. Disapproved ..._ _ . Date .._..(2 1 Notary Public, State of Florida (Signed) to me well known, ing Inspecctof My Commission Expires PLANNING BOARD DATE Chairman Member ...._ ...................... «._....... .... ...... --- 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 11.00 will be charged when such re- inspection is made necessary by improper notice for inspetiinn or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement or tile 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..._... "1 I Owner's Name and Address S/5 ,5 ' ....._._ _ No ,1�.__.. Street �� �Z -c? Registered Architect and /or Engineer ..,. ,-, - T,,••••.,c.,tt.- Name and address of licensed contractor /?4 /7 G l? C c it,/ S i. >7-5-0° /.v • z if 0C Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done _.__....__..._._.. __ State work to be done and purpose of building (by floors) c ` S v �/ C K y S is t/c and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation 11 Ro f vering Estimated Total cost of improvements $ 5 O ` v ' c, 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 budding and its construction may be sent to.. The umlevsige,cd 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 arc 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)........ 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 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 ' aare / tt ' rue. p Permit No ©4 (2 Date ") //CI Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Notary Public, State of Florida Buil ing Inspector My Commission Expires PLANNING BOARD DATE Cirair:nan Member \fcrnber 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 Ito.rrd. A re 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. STATE OF FLORIDA, COUNTY OF DADE. ss• MIAMI SHORES VILLAGE uilding Inspector BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby mode for the approval of the detailed statement ur 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 ......... C SR s ._ No._. // ZS..» . Street_. �`r •. 9�,y.. ?.... Registered Architect and /or Engineer Name and address of licensed contractor .J.`Y '.. " tR m'.1 Location and legal description of lot to be built on: Lot Block peared tf .�, r dPo/l`T .X(1O N. Li. /Z,,/ :Ti. M i gns (Signed) ,121 Subdivision VIII ••*tit •.ftft.TTltf.M! Street and Number where work is to be done State work to be done and purpose of building (by f l o o r a ) . . . . k r i e . SsrIt K 1 2 / La t rN• ,? .._ / " oic fo r .. Pi r lit - •,+. ..R a PK� (-r.M Notary Public, State of Florida My Commiuion Expires and for no other purpose. Repairs �^ F No. of Stories Roof Covering New Building Remodeling Addition To be constructed of Kind of fou Estimated Total cost of improvements $ Pao 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 Keith 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 pcnnit, as are licensed by Miami Shores Village. Remarks - --- Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- 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 fads therein by him stated are true. q I Permit No.._. (2._..x4 Date.. ,�. �.�.Q. ..... _......_._ Read, Sworn to and Subscribed before me. P Disapproved Date.. (Signed) PLANNING BOARD DATE Chairman _. Member 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 Pl.rnnir'.;; Board. A re fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty materials anti /or workmanship.