BUILDING PERMITApplication is 1(ereby ma 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 _w`ith the Building Ordinance of Miami
4 Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances 'Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether specified or not. A copy of approved
plans and specifications must be kept a$ building during progress of the work.
f '
Owner's Name and Address a re PC D� No.
Date
4,0Q7 s N )Qi
Name and address of licensed contractors -� _
Location and legal description of lot to be built on:
Lot w Block Subdivi 'on__ �J
Street and Number where work is to be done — — l--'-- -- /' t>' -
St work to be done an purpose of building (by floors) ---2-17— C
Registered Architect and /or Engineer
New Building Remodeling
To be constructed of C -7 5' K' of foundation
Estimated Total cost of improvements
Zone cubage required /
Distance to next nearest building
Maximum live load toobc borne by each floor Gz <
I hereby su ' all the l sp ific. • aid building. All notices with referen t the building
be sent �1
The undersigned applicant for this bu' : mg permit does hereby certify' that he understands and accep{s his obligation as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws 6f Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
m 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 p rformed under this
permit, as are licensed by Miami Shores Village. ��
!/ ; .7
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
/ /
MIAMI 3H -SIRES VILLAGE
BUILDING INSPECTION DEPARTMENT
-APP feATION FOR BUILDING PERMIT
'D
and
_Size of Building Lot
No. of
Roof Covering
Amount of Pe • it $_i}�
flan Cubage 1 • t �2 7/'
%oo
Read, Sworn to and Subscribed before me.
for no other purpose.
Sto 'e
! 27'
truction may
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he s the
of the above d cr • ed co .. tion, that he has efylly r�d the forego' g application, and that he did sign the same, and that all facts
therein by hii a e...:: taw ,,.✓a
Permit
I1iss prnved /° ate
(Signed)
Building Inspector
Notary Public, State of Florida
My Commission Expires
PLANNING BOA 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.
STATE OF FLORIDA) SS
CO , Y •� D )
State of Florida, being duly sworn, doth depose and say: that under the provisions
of Section B•368, Sub - section (d), of the Building Code of Miami Shores Village
he desires to build c r „ _ - k ;,ot„2 _-
Block 5
property, and will do the work personally, and that he will, at such times as are
required by the Zoning and Building Director:
1. File plans and specifications and obtain approval of Village Planning Board
and of the Building Inspector.
2. Apply for and secure a permit.
3. Pay the required fees for license and for permit.
4. Execute the work in accordance with the provisions of the Zoning, Building,
and Electrical Codes of Miami Shores Village.
5. Apply for inspections.
6. File with the Building Inspector certificates that provision has been made
to carry the nocessary Workman's Compensation, Public Liability and Property
Damage Insurance.
7. File with the Building Inspector as the job progresses certificates showing
the payment requirod by the Federal Social Security Act to the State of
Florida or the United States of America.
Assume tho responsibility of not employing contractors or sub - contractors
other than thoso properly licensed by Miami Shores Village or any part or
portion of the work including, but not limited to, gonoral contracting,
plumbing, heating, oloctrical, septic tank, solar system, lathing, tile,
torrazo, painting, roofing and shoot metal work or installation.
9. Not sot himsolf up as a "Contractor °.
10. Exocuto Builder's Bond.
"
And further this Deponent says not.
AFF 1:nA7 T T
2 /29 of the Village of Miami Shores, County of Dade and
subdivision; that he is the owner of said
1.
ZE
/ 4 SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY of A. D., 19
2.
1. Signature of Applicant.
2. Signature of Officer administering oath.
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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 C.RVJ • MATWg.-$oa
Registered Architect and /or Engineer
Name and address of licensed contractor CA. o.AJ /.0.14. C..0 • ) 554 W • S_ GIL sr •
Location and legal description of lot to be built on:
Block Subdivision
Lot ,1
Street and Number where work is to be done__._ t�_!.. • 9_2_._ •
State work to be done and purpose of building (by floors) t44said..E t l .o • p- J qt Li $ Sv a —
f t-oQP.._.. AND - -- _ .PN ovi- _kj.►?.K.._fikW • ge.9 !Amu A F4-90 tz — 4[Jo ... is,
j161__�.1,*4't
2 54 4 n!.6k�e. • —
and for no other purpose.
New Building Remodeling Addition Repairs le.'" No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ .. .6) .0 a•• 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 .554__A) • J • 54 57- •
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 tractors or sub- contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted .r ins on on ite o he work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such +.ubco tors, on ork be a formed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signe • � _ A _ I 4 1
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 true.
Permit No i ? i C3 Date ` C (.:5 a Read, Sworn to and Subscribed before me.
Disapproved . Dat
(Signed) r %, %,,
Building Inspegtor My Commission Expires
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date
ANvhP-x — L , 19.64`
No 3 di Street__.N,a_P '1 2 Sr.
to me well known,
Notary Public, State of Florida
L ANN1NG BOARD DATE
Chairman 1 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
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.
MIAMI SHORES VILLAGE
— DC r , t , D0 IT(
o a
BUILDING INSPECTION DEPARTMENT
// �(� Date
Owner's Name and Address ..Gc:..P � ' 2 � S' / �L- 2ZW es U4
Registered Architect and /or Engineer .- . M - S
Name and address of licensed contractor-- _1I�L ^.-� L�
Location and legal description of lot to be built on:
Lot t Block
Street and Number where work is to be done
Subdivision_.._
State work to be done and purpose of building (by floors)___C. rn_i_7.2 c.
No. 4 ( Street
R Tt+ S can e'ey
' 19.J6'?
"--
o �
and for no other purpose.
New Building Remodeling ddition L� Repairs No. of Stories
To be constructed of .._ / Kind of foundat' n.... C O At 6- Roof Covering 18 1."'i / 731G�
Estimated Total cost of improvements $ J' 90 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 su- s ub�fintractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signe
4
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 true.
Permit No C ' Date ,. Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
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