126 NE 93 StI hereby submit all a plans and specifications for
be sent to.
is
STATE OF FLORIDA,
COUNTY OF DADE.
Disapproved
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby urndc for the approval of the detailed statement us me plans and specifications herewith submitted for the build
ine 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 bc kept at building during progress of the work.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor Se
Location and legal description of lot to be built on:
Lot.. // Block a 3 Subdivision& S ' / 4 1L a� L 3 /j0
Street and Number where work is to be done....t 1
State wok to be dope, and purpose o building (by floors ........1..
�
.
n . ► ._ . —b'.. . P- ..... ay t \ CA rO4
SS.
Date..
No...
Date..._ _ . .... _ ....__.. ... , 19.;.214
._ 1 _..__— S i . _ (. E M
_. Street � )
Rtt H•• *tilt fOt11RtflHt• TT ,tt.
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories _
To be constructed of Kind of foundation RoL:1) Covering
Estimated Total cost of improvements $ Q- Amount of Permit S. I®
Zone cubage required .Plan Cubage
Distance .to next newest building Size of Building Lot
Maximum live load to be borne by each floor
said building. All notices with reference to the building and
The undersigned applicant faf 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 Sup ile•nrent,
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 bc 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-
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 true.. 9114—
Permit No.._. .L :L% Date -14 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector My Commiuion Expires
its construction may
to me well known,
PLANNING BOARD DATE
Chairman Mcmbcr
\ferr1ber 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 1'l.innir•;; hoard.
A re inspection fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspection oe faulty
materials and /or workmanship.
3,00
Q i &5o'
��. Ft. • 33138
♦ t.
LOT // 4A' BLOCK 23
SUBDIVISION 21/U A A P PLAT op • Al D A A 5, R S s EC r/ Q Al .(JO. /
ACCORDING To_ THE-- LAT. THEREOF AS RECORDED IN PLAT BOOK / D AT PAGE 74 OF THE
PUBLIC RECORDS OF DA COUNTY, FLORIDA.
RES,. /l1Q . /Z6 . A.. ) E. 93' . r. 4M1 SNorzas, Fe... 33l'a8
CE12 / A7EIS 7-D t A M ERIc'AA) SOOT HEFLO rt' .e.7 COAPORAT /DAJ
FOR: R A`/
aV__- 93 S7
NOT VALID UNLESS EMBOSSED SEAL
LEGAL DESCRIPTION
LOCATION SKETCH
SCALE: 1" = 24 •
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WE HEREBY CERTIFY: That the attached SKETCH OF SURVEY of the above described property is correct to the best of our
• knowledge and belief as recently surveyed under our direction, also that there are no encroachments unless shown, and this survey
meets Minimum Technical Standards set by the FLORIDA BOARD OF LAND SURVEYORS. as set forth in Chapter 472.027 (F.S.)
and Chapter 21 HH 6 of the Florida Administrative Code.
ORDER No gets O7 — C.5 PROFESSIONAL LAND SURVEYOR No. 3/D 6
STATE OF F ORIDA
DATE U L `7' ?, / �8
CARIBBEAN LAND SURVEYORS,` -INC. `-
7175 S.W. 8th STREET, SUITE 216
MIAMI, FLORIDA 33144
TELEPHONE (305) 264 -9151