33 NE 93 St (2)qqq
BUILDING INSPECTION DEPARTMENT C- "
MIAMI SHORES VILLAGE
APPLIE _ TION 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 ✓< a, S
No 3 3 AI` i Street
Registered Architect and /or Engin4r
1 70 P(f to c. te7, /IN 0
Name and address of licensed contractor It (tTO
Location and legal description of logo be built on:
Lot Block Subdivision
Street and Number where work is to be done 3 3 'u • 'Q ' e33 •.4 -
State work to be done and purpose of building (by floors)
A.Ove r
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 $
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) _
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
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.
3 Date d
Permit No ___ � 1 Read, Sworn to and Subscribed before me.
� ____
Disapproved c. Date
7 /9Ot' R0of1`119.*
Notary Public, State of Florida
(Signed)
Building Inspector /} My Commission Expires
PLANNING BOARD __.. DATE
Chairman Member
Member _ Member
Member ... _ - . Member
Council Approved
Date 0 1 14 :j "Z-______ . 19 73
g 3�
to me well known,
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 51.00 will be charged when such re- inspection is made necessary by improper notice for inset, don or faulty
materials and /or workmanship.
N.r r.
CA 2 L-
C - 7 e / i s Ce'C
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i V C e- DA-0 L- Q.... F'[ K Ss
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tractor - Li
02a Lot ic Bl.
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dress of ,. ,
oil dili , ...?.. 1 i ...• . r
,
4 ' • '— • I ' .
In consideration of the issuance to me of this permit I age
4ning thereto -and in st with the plans, drawings,
tpnptj t I e reeonsibility for all work done by ei
MIAMI SHCIREEI VILLAGE, FLORIDA
ICU Li PERMIT N? 10931
Work to be performed under this Permit
4iitect
3
i
Subdi-
vision '
Value of
Project $
Br
Ad,
DATE 2.1 19_
Contractor's
License No,
= t
f
Amt. of
Permit
iZL I
$ /
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
1 2--efor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
itti* gs, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at an.7
...= 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 perailt is
gited is the understanding that the contractor or builder named a ve assumes the res sibility for a thorough knowledge of the ordinances and
to the work covered hereby whether shown on the plans r dra in or in s e s or specificati and that assm sib
is agents, servants or employees.
INSPECTOR
-
to erform the work covered hereunder in compliance with all ordinances and regulations
ts or specifications submitted to the proper authorities of Wird Shores Valage.
her, myself, my agent, servant or employee.
4.'
1
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
STATE OF FLORIDA,
COUNTY OF DADE. j Ss.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Location and legal description of lot to be built on:
i
Lot i - --.. Block ` ? Subdivision s \
(I r
Street and Number where work is to be done i .
State work to be done and,purpose of building (by floors )_
a •
Remarks ( Signed)
Date
No. = Street _
f
•
' f and for no other purpose.
New Building Remodeling Addition Repairs v No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required plan Cubage
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
. 1
be sent to --'_ L' ' _+ s ' - " t ',, - — - - - -L__:_1.-_,_k.... - .
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 su • : tractors, on work to be p rmed under this
permit, as are licensed by Miami Shores Village. E jij �,, O '
r 47 (
Size of Building Lot
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 ire true.
/' /
Permit No t� :� '1 Date � J / �• �� � V Read, Sworn to and Subscribed before me.
Disapproved Date
f
.0 e ; r / Notary Public, State of Florida
(Signed) _ 40---.
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.