WINDOWS/AWNINGSState wok to be done and
Ncw Building Remodeling
To be constructed of
APPLICATION FOR BUILDING PERMIT
.Application is hereby spade for the approval of the detailed statement ut 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'n( the State oaf 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 specilhied or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
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��// Date..._...?- / -_' -- c .._.... 19. (�
Owner's Name and Address ������H& e c A _ No'7►.'.u!a' Ale: Str 3 T_Ai ;/97 4/5"
Registered Architect and /or Engineer t.... ...•••,,. .......... .. .�t:,/i2,Q.4../ 4,A,) '7 r... /4'Ve
Nuns and address of liccnsed contractorJE 1 ,Y.lII24 .6.6.7 4 6 ;6eCC III L_ . i9L^..'1. '... . _3 3!6 C
Location and legal description of lot to be built on:
Lot g Block - - 1 Subdivision. .. ,4..6 ' g .._.._.._JI A._... r 'J r
Street and Number where work is to be done .. 6... 6' _ i 3 ...5- ', S /'i'1
urposc of building (by floors) _ .
. .
GO C Y'rs -? .. _.J `E'T'✓ /^! ( r7i'0 6_C .6/u 4)6S •
c41J Ef.
and for no other purpose.
Addition Repairs No. of Stories _
Kind of found pe Roof Covering
Estimated Total cost of improvements $... `Y °a' Amount of Permit $..../. - ' •
Zone cubage required plan Cubage
Size of Building Lot
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 tbur under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid., Permn:tnent Supplement,
and has complied Stith the provisions thereof, and will require similar compliance from all contractors or sub- tractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for spection on the site o, the work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such s r ntractors, on , / o be performed under this
pcnnit, as are licensed by Miami Shores Village.
Rem.uks (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 SCi --taw Gc 7-sn't,C_
and who, being by me first duly sworn, upon oath deposes and says that he is the. C"At`"'"""‘,.
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 `i .1� Read
Disapproved �_.. e _... , Date
(Signed)
Building Inspector
Chairman
Member
Member .. _.....__..._._..._._...._.._.._
Council Approved Date
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
worn to and Subscribed before me.
Member
Member
Member sass_
to me well known,
Notary Public, State of Florida
My Commission Expir4p .T.gj(?.-4J8LICST.EITI.PF, FLORIDA 1
MY COMMISSION EXPIRES JULY 25 1967
PLANNING BOARD DA'1QENDED THRU GENER ^l "S
Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application niter approval has been obtained from
the Planning Board.
A rc•in'peetion fce of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials anu /or workmanship.