275 NE 92 St (11)Owmpr's Name and Address._.
RegF,?ered Architect and /or Engineer._. _
Name and address of licensed contractor
Locatio an4 legal descr•)BEipai f ' be b�ui� on:
Lot Block
Maximum live load to be borne by each floor___
I hereby submitall
be sent to.__._
permit, as are licensed by Miami Shores Village.
Remarks
Permit No
Disapproved
(Signed)
c
Chaihnan _
Member
Member
Council Approved
Date__
Building Inspector
PLAN •d G BOARD
Date
1
MIAMI SHORES VILLAGE
BUILDING INSPECTION • DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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.
- -- �'°\ l am__ - ._ ___ ._ • _ ..__
No d. 3 ___ Street_
Subdivision
Street and Number where work is to be done - VS - ei—_I
State work to be done and pu o of building (by floors) _. N lIfkz4=4 __ -- -- - --___ =' ` ',. °--
- - - -- - - -- and for no other purpose.
New Building Remodeling Addition __ Repairs No. of Stories 1„...
To be constructed of Kind of foundation.._.. Roof Covering _...._.
Estimated Total cost of improvements $ __l___D _1_ _- Amount of Permit $ 10. 00
Zone cubage required -Plan Cubage._ _.
Distance to next nearest building__..__.. Size of Building Lot
ans and ec ations for \ said building. All notices with reference to the building and its construction may
The undersigned applicant for this building permit doe 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, Pennanent 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 su .co tract.rs, o wor .S o be performed under this
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 sited are Jyue. -
S Date.___.. Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires__
DATE
Member
Member
Member . _._..._ ....
Disapproved
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 b
materials and /or workmanship.
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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.
Owner's Name and Address
Registered Architect and /or Engineer
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 __ .z___. __
State work to be done and purpose of building (by floors)_
Disapproved
(Signed)
Date ��u
and for no other purpose.
New Building Remodeling Addition Repairs i!' No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $_ /JD 0 Amount of Permit $ 1• 0"0
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 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 _4,Y L _l : c
STATE OF FLORIDA,
COUNTY OF DADE. j 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.___ Date ?/ �v Read, Sworn to and Subscribed before me.
Date
4 Notary Public, State of Florida
Building Inspector My Commission Expires
Chairman
Member
Member
PLANNING OARD DATE
Member
Member
Member
a)c-9 ,1
Street
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.
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.
Owner's Name and Address
Registered Architect and /or Engineer
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
STATE OF FLORIDA,
COUNTY OF DADE.
Permit No
Disapproved
(Signed )
}
ss.
A, (6 e (r. k a v1/4
Date
No.
-
State work to be done and purpose of building (by floors) .1 _ it w._ R /?E MI 6 A
MA/ R T 6/7
and for no other purpose.
Repairs t No. of Stories
New Building Remodeling. Addition
To be constructed of Kind of foundigis Ro o C vering
Estimated Total cost of improvements $ ��`� 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 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 ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on w k to be perfo under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) _ � 1 � 1 ) ,
Street ,Crzei g
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.
l' --
Date Read, Sworn to and Subscribed before me.
m ate
Notary Public, State of Florida
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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
L1r,�C1 ui��;t�ta
MIAMI SHORES VILLAGE
New Building
To be constructed of Kind of
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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.
Owner's Name and Address a '� ln-Si No ` 7 / Streeth (�?
°' - web to 1,1 iyo
Registered Architect and /or Engineer
foundation
Date
Rerning. Addition Repairs
«/* en , 19
Street and Number where work is to be done 2. e 9 1
State work to be done and purpose of building (by floors) y' °
t = = =„ P,
and for no other purpose.
No. of Stories
Roof Covering
Estimated Total cost of improvements $ 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, Pennanent 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 subcontracts, on wor to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
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.
/
Permit No � r 7 / p Date 4-- Z Z b Read, Sworn to and Subscribed before me.
Date
Disapproved
(Signed) f1 )
ss.
to me well known,
Notary Public, State of Florida
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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Zone cubage required
Distance to next nearest building_
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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 building
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 regula-
tions of the Building Division of Miami Shores Village shall be complied with, whether here. specified or not. A copy of approved plans
and specifications must be kept at building during progress of the work.
Building Inspector
Owner's Name and Addres s
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be b ilt on: .
Lot___ �_�_____ _ Block _____ Subdivision
Street and Number where work is to be
State work to be done and purpose of building (by floors)
--- - - -- -- � / ----- --- --- - - - - -- -- -- --- ------ --- - - - - -- --- - - -- -- -_and for no other purpose.
New Building v Remodeling__ Addition___— ______— Repairs _ No. of Stories
To be constructed of__-- _— _________ Kind of foundation_
Estimated Total cost of improvements $_— ` dO _ _ — _Amount of Permit $
Date_
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member - Member
Council Approved_ — ____— _____� _— ___— __Date Disapproved
_� _ — - 19
,� Street— / P (2?
Roof Covering __________ ____
____-- __ — _____
--_Plan Cubage
Size of Building Lot __________ _______________________
Maximum live load to be borne by each fl oor_— ___--__ — ________ — ____ _____________,__�_- -__�__
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. rs
Remarks (Signed)"
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him s ted are tru
Permit No. ___ Date Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Notary Public, State of Florida
to me well known,
—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.
(over)
1. General Building Contractor..
LIST OF CONTRACTORS, SUB - CONTRACTORS, ETC.
REQUIRING OCCUPATIONAL LICENSES
MIAMI SHORES VILLAGE
2. Plumbing, Heating, Ventilating, Air Conditioning and Gas Fitting.
3. Electrical.
4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators.
5. Excavating, grading, filling and Landscaping.
6. Moving or wrecking.
7. Septic Tank and Drain Field.
8. Brick, Stone, Tile, Cement Block, Concrete and Gypsum.
9. Carpentry, Millwork, Awning and Shutters.
10. Cement, Lime, Plastering, Stucco, Lathing and Cast Stone.
11. Decorating (interior and exterior), Painting, Waterproofing, Damp- Proofing and Paper- hanging.
12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring not otherwise
specified.
13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors.
14. Roofing, Sheetmetal and Skylights.
15. Solar Water Systems.
16. Well drillers.
17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc.
18. Structural and Reinforcing Iron and Steel.
19. Tile, Terrazzo, Marble, Granite and Cut Stone.
20. Electric Fixtures.
21. Illuminated Signs.
22. Bridge, Bulk- heading,, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga-
tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work.
23. Every person, firm, co- partnership, Corporation, Association or other organization engaged in the bus-
iness of supplying, furnishing or delivering building materials for any construction project within the
Village Limits and not having a regularly established and licensed place of business in the Village.
MIAMI S HOPES VI LLAG E
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 building
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 regula-
tions of the Building Division of Miami Shores Village shall be complied with, whether here' 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
Registered Architect and /or Engineer_
To be constructed of__
Permit No.__
Disapproved
(Signed)
Building Inspector
Name and address of licensed contractor_ c° -'
Location and legal description of lot to be b ilt on:
Subdivision C
__ ,
Street and Number where work is to be done .d
State work to be done and purpose of building (by floors)
g Remodeling __ Addition Repairs
New Buildin —____ Remodelin No. of Stories______________
Kind of foundation_ Roof Covering _
Estimated Total cost of improvements $ $ ml
Zone cubage required_—____________ —_____ Distance to next nearest building
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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. . -; '
Remarks (Signed), 4 ,Z4 f' 4-'
STATE OF FLORIDA, 1
COUNTY OF DADE. j sa.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
and who, being by me first duly sworn, upon oath deposes and says that be is the _
of the above described construction, that be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him sited aretru
Date Read, Sworn to and Subscribed before me.
Date
(over)
-- ' D -- - - -. 19_ _ C,
-i Street P ) • £
AO
—Plan Cubage
Size of Building Lot
Notary Public, State of Florida
My Commission Expires
_and for no other purpose.
to me well known,
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.
LIST OF CONTRACTORS, SUB - CONTRACTORS, ETC.
REQUIRING OCCUPATIONAL LICENSES
MIAMI SHORES VILLAGE -
1. General Building Contractor.
2. Plumbing, Heating, Ventilating, Air Conditioning and Gas Fitting.
3. Electrical.
4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators.
5. Excavating, grading, filling and Landscaping.
6. Moving or wrecking.
7. Septic Tank and Drain Field.
8. Brick, Stone, Tile, Cement Block, Concrete and Gypsum.
9. Carpentry, Millwork, Awning and Shutters.
10. Cement, Lime, Plastering, Stucco, Lathing and Cast Stone.
11. Decorating (interior and exterior) , Painting, Waterproofing, Damp- Proofing and Paper- hanging.
12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring not otherwise
specified.
13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors.
14. Roofing, Sheetmetal and Skylights.
15 Solar Water Systems.
16. Well drillers.
17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc.
18. Structural and Reinforcing Iron and Steel.
19. Tile, Terrazzo, Marble, Granite and Cut Stone.
20. Electric Fixtures. .
21. Illuminated Signs.
22. Bridge, Bulk- heading, Drainage. Sewer, Water and Gas excavation and Construction, Dredging, Irriga-
tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work.
23. Every person, firm, co- partnership, Corporation, Association or other organization engaged in the bus-
iness of supplying, furnishing or delivering building materials for any construction project within the
Village Limits and not having a regularly established and licensed place of business in the Village.
Ov:n r s Name and Address..Mx,.._.
RegI eyed Architect and /or Engineer p_._�
Name and address of licensed contractor �,a ._
Location and legal description of lot to be built on:
Lot Block
STATE OF FLORIDA,
COUNTY OF DADE.
Disapproved
(Signed) u% `
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.
Street and Number where work is to be done
State w rk to be done and purpose of building (by floors)._
New Building Remodeling
To be constructed of Kind of foundation b
Estimated Total cost of improvements $ �.Q� � — 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 foi 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)
ss.
MIAMI SHORES VILLAGE
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
UILDING INSPECTION DEPARTMENT
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 (74,7 Date____. i?5 —1
Building Inspector ` My Commission Expires
Date____ p / t . , 19
No.. . )i7Vk Street e1c7
-.. / /0 ijId /ic
Subdivision
and for no other purpose.
Addition Repairs No. of Stories
Roof Covering
p C o
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
to me well known,
PLA G BOARD __ . DATE
Chatrnan _ . 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.
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 Villag3, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village 9nd all rules and
regulations of the Building Division of Miami Shores Village shall be complied with. whether herein specified el not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address ` ' do ( -e [ 2 e 1 ` �� a _ No.___ . ?r. ___ _ Street___ !U : i = _ _ 7 z _ .J r
Registered Architect and /or Engineer
Name and address of licensed contractor_____________ 24Y .C16c £'-
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 ilding (by floors)__
C E er. c. / 54, s ����'+X r�QL �a y i 4aQ n �� _ and for no other purpose.
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 $ L. _
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, Pennanent 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 u r 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
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 tru .
Permit No.__ 7 _ Date l C-7 Read, Sworn to and Subscribed before me.
Disapproved
(Signed) (.� (
A
Building Ins ctor
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
PPLICATION FOR BUILDING PERMIT
Date- l Is G
e a 6--
to me well known,
Notary Public, State of Florida
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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.