1276 NE 93 StOwner's Name and Address
Disapproved _ ate_
(Signed) __ Building spector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR : IJILDING PERMIT
Date
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.
f ,196P7
le i __ll C / No. Street r7 lr V .tr/
Date / _�'"
Registered Architect and /or Engineer ®� y f-4/
Name and address of licensed contractor 01.?�
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done A 6 �r_. �A
State work to be done and purpose of buildin (by floors) r / #1
" , ? � 1 � a nd for no other purpose.
1 • �� P rpose.
New Building Remodeling Addition._ Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $ 4
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 with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be perforined 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 subcontracto on work to be perfor ed under this
permit, as are licensed by Miami Shores Village. —^
Remarks (Signed).. !. j _ f
STATE OF FLORIDA, 4
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 are true.
Permit No t Z +�
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman f Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be spade 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.
1
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ PERMIT N° 6225 Contractor's
PLUMBING ❑ License No.
ROOFING ❑
Owner of
Building
A te,
Architect
Contractor „
,or Builder ;
Legal Lot
Description Bl.
Address of
Building
Work to be performed under this Permit
Value of
Project
Signed. �" �
INSPECTOR
DATE ` � � 195 11
Subdi-
vision
B
"
Amount of 2 r
Permit $
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 application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any 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 named above assumes the responsibility for a thorough knowledge of the ordrnances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings in the sta ents or specifications a d that he assum responsibility for work
done by his agents, servants or employees.
In consideration of the issuance to me of this permit I agree to perform the work covered hereun r in compliance with all ordinances and regulations
pertaining thereto and in rict conformily with / the plans, drawings state is or specifications., bmitted o the proper au rfties of Miami Shores Village. In ac-
cepting this permit I assdme responsibility far all work done ei e� self my agsti-- ant or ezployee.
CONTRACTCR OR BUILDER BY
AUTHORITY
• 6 :
WORD IIDIESCIIB)IRII'IION
ri V a .
IFERIViI T AIFPU CATII
1)
N FOR MIAMI SH
1)
3I
ES VILLAGE
Job Address /2 74 lvc 9 2 ecL S7 Tax Folio
Date
/
Legal Description Historically Designated: Yes No X
Owner/Lessee / Tenant -- SO C � In e Master Permit # L i OS
Owner's Address /2 7 4 f v -g . °/ 3 177 Phone 30 S. 7S 7 -11/7
Contracting Co. ���� �t (= �✓ Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): 't;UJELIDIING \ ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
C ` �w /FA l( /,vied (ock /&J (or.;cic p,$v ei. s mA/ I�i✓� iN
e1re -¢ hr,y7AJ ,/use %ter bb- A
Estimated Cost (value) e 2 .
Square Ft. / 2 Da st7
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAIILURE TO IID +h SO MAY
RESULT IN YOUR PANG TWICE FOR IMP OVIEMENTS TO YOUR D * PERTY (IIF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOU r, LIENDE e; OR AN ATTORNEY IBEF =IRE RECO , IP ING YOU NOTICE OF COMMENCEMENT.)
Signature of owner and/or Condo President Date
1014%
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
/e /io%
Notary as to Owner and/or Condo President Date N as to Contractor .�. I wner- Builder Date
My Commission Expires: y Commission Expires:
Fi 5't
FEES: PERMIT RADON C Y / ° NOTARY
APPROVED:
Zoning Building
Mechanical Plumbing Engineering
Electrical
BOND
TOTAL DUE 3 GI
c"�
O
CN
10'
N
75.000
HOUSE
1276 NE 93rd Street
Materials
4" Brick Pavers installed in existing asphalt driveway area
Brick pavers installed on sand
10°