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MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade 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 Villap 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�`- Date... .._.. .ate ..L '.._ _._..._._._.......... ,1
Owner's Name and Address VOW • 44.!k.O GIA .1ALEL .... No. . . Street. ... 9. M `r
Registered /or Engineer rRp' =' 9 -- S- t LDQ.7.1. �/
Name and address of licensed contractor...Pt PQo.L�-s -FM/4420>V ST gel-W
Location and legal description of lot to be built on:
Lot 1.12 ° —"/ Block. .ja.. Subdivision: VI t S
Stzeet and Number where work is to be done.. — ZOO _ ,. • �. .__....
State work to be done and purpose of building (by floors)
Cif- I - )T 9 N>rli.�l �i _t l!o lc 3 e Tern -
t, -
13 s� a-L - P k A :.2.,__...._�.°?�''_ .__ and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
�a
Estimated Total cost of improvements $. ...1.�. aY��.. o 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
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.... RC.1..1._Q t- ?oo S FU_. N.. 7d ..,1.....T.,...7d- -vr/kQ.-0n
The undersigned applicant for this building pennit 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 ubcontractors, op work to be performed under this
pennit, 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
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 e.
Permit No .___ L�l _)
Date
Read, Sworn to and Subscribed before me.
Disapproved ..... Date
Notary Public, State of Florida
(Signed)
Building nspcctor 7 My Commission Expires
PLAN If NC 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 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
fiction
Pool guildep.4 9nc.
5906 Funston Street
Hollywood, Florida 33023
962 -4426
MAY 21, 1974
ATTENTION: MIAMI SHORES BUILDING DEPT.
I STEVE GRECO AUTHORIZES PAT McFALL TO PICK UP BUILDING PERMITS
ON POOL STRUCTURES.
SIGNATURE
STATE OF FLORIDA
COUNTY OF BROWARD
SWORN TOO AND SUBSCRIBED BEFORE ME THIS ,c / DAY OF 19 79
NOTARY PUBLIC, STATE of FLORIDA at LARGE
MY COMMISSION • EXPIRES JULY 19, 1977
BONDED .TNRU MAYNARD BONDING AGENCY
tkv
MY COMMISSION EXPIRES NOTARY PUBLIC STATE OF FLORIDA AT LARGE
44
mr
HARRY TELLAM
& ASSOCIATES
vAtiee
u,,t ,d6" &Z;_
HARRY TELLAM & ASSOCIATES INC.
157 Harbor Drive / Key Biscayne, Florida 33149 / Phone 361 -2523