270 NE 92 St (2)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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.
(%—° s /' Date - = � . om - ¢ y' t. , 19
Owner's Name and Address f' 1, ) � - ) %„ No 0 •% . _ ___ Street /.� , � ''_FL )� /`
Registered Architect and /or Engineer J i r
Name and address of licensed contractor___!_
Location and legal description of lot to be built on:
Lot Block__ Subdivision
Street and Number where work is to be done __
C
:ate work to be done and purpose of building (by floors)_ � ' ' � �`
7)z )`/, 9 e
( . ! //
STATE OF FLORIDA,
COUNTY OF DADE. ss.
and for no other purpose.
New Building Remodeling Addition Rep ii's' No. of Stories
To be constructed of Kind of four ation __ Roof Cove ;ing
Estimated Total cost of improvements $__ � Amount of Permit
Zone cubage required _ 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 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 Jcon actor , n work to be .p armed under this
permit, are licensed b Miami Shores Village.
'
Remarks ( Signed ) _
P Y /
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 descr ed constr cti that he has caref fly read the forego' g application, and that he did sign the same, and that all facts
therein by him st ed are
Permit No. _ __ ,/ O { ____ Date L- ' (C 1 mead, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
Building Inspector
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 $L00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE 194
N° 6138
Work to be performed under this Permit
Contractor's
License No.
e
Architect
Contractor �..- l
-
or Builder � 0.,...'
Legal Lot Bl. Subdi
Description vision
Address of ... . Value of Amt. o
Building .� .+` ..l Project Permit
This permit is grant to the contractor or buildemed above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w'th the understanding that the work wil 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 ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assume respon-
sibility for work done by his agents, servants or employees.
• i
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto anfl in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting t S1pef nit sume resp ty for all work done by either myself, my agent, servant or employee.
Signed •
By
CONTRACTOR OR BUILDER BY AUTHORITY
',BUILDING '
ECECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
/ a
b w •
CON ACTOR OR' /BUILDER
d tr4,4
v , /v / 110 e
MIAMI SHORES VILLAGE, FLORIDA �g ;
DATE t194_
PERMIT N° 4393 C / /" 9
Work to be performed under this Permit / 14' A ifiieeP9e*
f
Bl.
Signed.
Address o f o Value of �j �' Amt. of 0 0
t .
Building �✓ 6 ' � Projects/ (p 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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the stanents or specifications and that he assum s respon-
sibility for work done by his agents, servants or employees. .i� 4
By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with a]]Lg�rdinances nd regg�µ ons
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authooif% of Miamith&es` age.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
Subdi-
vision
BY
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Architect -.
Contractor
or Builder . y
Legal Lot w "°
Description
MIAMI SHORES VILLAGE, FLORIDA
f
PERMIT N" • 4393 Contractor's / r
License No.
Work to be performed under this Permit f
Owner of i r
Building + '
Bl.
DATE
Subdi- \ /
vision 4
Address of ' j ` i ' t "" Value of ,/� 3 . ` Amt. of
Building 1 ' -4, Project ! .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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w'th 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 ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statewents or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. ,_ i r
v.
.. • A• / B
Signed. INSPECTOR 1 By
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
J _ }
CONT i ACTOR OR BUILDER BY • AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Lot
Architect
Contractor
or Builder
Legal
Description
Address of
Building f
This pern5it'is - gran
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE / %. ,
194A.
PERMIT N® 6138 Contractor's
;lLicefise No.``
Work to be performed under this Permit
-'r
Bl.
Subdi-
vision
BY
Value of
Project i `7 /i
,
1 ,
Amt. f2"
Permit""
AUTHORITY
to t'I a contractor or builder" named above construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work wil 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 hpbn which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances ai }d
regulations pertaining to the work covered hereby whether shown on the plans or drawings, or in the statements or specifications and that heAssumes resprn-
sibility for work done by his agents, servants or employees. e Y . /
Signed. Z.
/ `,� / 0 ; By ;` it
INSPECTO` J
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Vill1ige.
In accepting t p Xmit ssume responsih9lit9 for all work done by either myself, my agent, servant or employee.