MECHANICALBUILDINGSPECTION DEPARTMENT
APPLIC TIGN' FOR BUILDING PERMIT
ApplicaLon is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other stru ture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Villag^, 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 Miam Shores Village sh :11 be complied with whether her .in specified cr not. A copy of approved
plans and specifications must be kept at budding 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. ss
Disapproved - t /_____ _ _- _ ___ ____ Date
(Signed)
Chairman
Member .
Member .
Council Approved __
MBANC SHORES VILLAGE
ng Inspector
Date V n IlA W v) e) , 19!4'x?
atE
PL ING BOARD DATE
Member __
Member _
Member
No._ C�a Stre x E
J0.2. 2. C. 9 �/
State work to be done and purpose of building (b fl '4, ors) �a �_L� — r _L �l( Co Obi X1 '1 8 Ai C
uc, ¢ w®q OF. EAT Pu'P P
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 4 O Amount of Permit $ , ' AU
Zone cubage required____ .______ _Plan Cubage
Distance to next nearest building_ . __ _ __ Size of Building Lot _
Maximum live load to be borne by a floor__
I hereby submit all the plans an specifications for said building. All notices with reference to the building and its construction may
,-
be sent to - - - - - -- -- -- - --- - --dz - =
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 sub •ntractors on work to be performed under this
permit, as are licensed by Miami Shores Village. t
o
Remarks -- ___ (Signed) .1. _ r .� J
•
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 —13-27 D a t e . — - Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
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.
t.
Permit No.
Disapproved 1 Date
(Signed)
Building Inspector
MIAMI SHORES VILLAGE
BCILDING 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 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.
A/c_ L /cam
Tc J 5 7r S i4 o
Remarks (Signed)
Date
Read. Sworn to and Subscribed before me.
6 -a,
Date 19_
Owner's Name and Address d L2i 1 TI I No 30 Street N 6 r>-- S T
Registered Architect and or Engineer
Name and address of licensed contractor - G - ,�, S
Location and legal description of lot to be built on: /I i q a e w / /,/ , 7 0® 9
Lot / �/a Block 4 S' Subdivision 1 ) t) ' 0 - 0 Hl ci m i q 'I1 c F s c 1 r-f /�
mTh
Street and Number where work is to be done = (. 'f - (9 Z
State work to be done and purpose of building (by floors). state exterior colors (submit samples)
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
� ‘57 c) 7l - zS
Estimated Total cost of improvements S 7 Amount of Permit S —°
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
1 hereby submit all 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 obligatons as : •mployer of Labor under the Florida Workmen's
Compensation Act. being Section 5966. Compiled General Laws of Florida. Permanent Supplement. and has complied w' h she 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 ill 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 agr tort tpl . o such §ubcontractors. on work to be performed
under this permit. as are licensed by Miami Shores Village.
:3
STATE OF FLORIDA
COUNTY OF DADE. } ss.
Before me. the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared
Notary Public. State of Florida
My Commission Expires
and for no other purpose.
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.
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of .S 25.00 will he made for making correc:ions or changes to this application after approval has been obtained from the Planning Board.
A re- inspection fee of 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship.
27'
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