FENCE PERMITS 90 NE 91 STBUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby umdc 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.
, 19 ..
Owner's Name and Address . . � �l / /J a); e 9c2 5 Street
Registered Architect and /or lynginccr .. .
Name and address of licensed contractor - U ' CT
Location and legal description of lot to be built on:
Lot / `F CAS 4.4 C -7 Block
reC7` o E
Street and Number where work is to be done
State work to be done and pis se of building (by floors)
Distance to next nearest budding
STATE OF FLO
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
Subdivision � te-7//1
?L
c . 3S6 ,&) C o 7_
- Sz-C (i o J-r
/
and for no other purpose.
New Building Remodeling Addition Repair: No. of Stories . ...
To be constructed of Kind of foundation Roof 9ovexing _
Estimated Total cost of improvements $ r l!
. 1 /0 0. 0 O Amount of Permit L....I A!
Zone cubage required Plan Cubage
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 construct j may
be sent to n
The undersigned applicant for this building perinit does hereby certify that he understands and accepts his igations as 'inployer
of labor under the Florida Workmen's orkmen's Compensation Act, being Section 5966, Com • ed General Laws of Flo . , Pennenrn p ,lenient,
and has complied with the provisions thereof, and will require similar compliance fn s all contractors or . ntractors em jed by him
in the work to be performed under this permit; and will post or cause to be posted f inspection on the site •f the work su• ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such s / ntra� s, o o� t. be perfo under this
permit, as are licensed by Miami Shores Village. I
Remarks (Signed) /t.._....__..
RIDA
' ' '• ' '`4 . tBefore me, the undersigned authority, a notary public, duly authorized to adns ' ter oaths and take acknowledgments, personally ap
i' .0 AO Pl1BLiC STALE OF rLOkIDA Ai LARGE
peaked MY COMMOSION f,XPIRES 19 1982
6 O 1 'DED TlifiVaMIAL INS. 1fYlliEi;s
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 carefull read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No A0 Date )1-4 7 9
- Read, Sworn to and Subscribed before m
Disapproved ate C� 4
(Signed)
Building Inspector My Commission Expires S `� T ' y � 7 ��� (j �
Nura� rUDLiCSTATE OF r LOB IDA AT LA.RG:
MY COMMISSION DIMES HI. 19 1981
PLANNING BOARD DATE BONDED MU MUM 14.1 WRIray
Cnair:nan Member
Mcrnbcr Member
Member .. .. Member --- -
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained fmm
the 1'Lumin4 Board.
A re ,n,t fee of 51.00 will be charged when such re inspection is made necessary by improper notice for inspection or faulty
materials anti /or workmanship.
Not
y Public, State of Florida
to me well known,
0
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
I Date
Owner's . � s Name and Address ..... .h P° _ .F d .._..» No
Registered Architect and /or Engineer _ - -1
Name and address of licensed contractor Oe
Location and legal description of lot to be built on:
Lot Block Subdivision �y -
Street and Number where work is to be done ! tf • 1/47 1
State work to be done and purpose of building (by floors) ..... ............. ___........
_.
61 r x Ile i! .T. ..,
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
6 4 _..A r w e L 'ac ,. . and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of. Kind of foun$tion a Roof Covering
Estimated Total cost of improvements $ Amount of Permit $. 3 ��
Zone cubage required . plan Cubage
Distance to next nearest building Size of Building Lot
Maxirnum 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 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)
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 ar .
Permit No._ __l Date Read, Sworn to and Subscribed before me.
Disapproved / Date._
(Signed)
Building Inspector
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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Notary Public, State of Florida
My Commission Expires
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g epAt46..
Feos c€ ,/ed &e.
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