Loading...
80 NE 92 St (10)MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement ur the plans and specifications herewith submitted for the build • inc 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 progreu of the work. g--) op Date Owner's Name and Address 0.c. 1)1 IV IJE L - S� _ No. Registered Architect and /or Engineer p QS� e t, i e- Name and address of licensed contractor 8 g.5 Location and legal description of lot to be built on: Lot Block Subdivision.. Street and Number where work is to be done `� State work to be done and purpose of building (by floors) STATE OF FLORIDA, COUNTY OF DADE. i as. Before me, the undersigned authority, peared Building Inspector NOTE: A charge of $1.00 will be made for the PI,umnir,;; Board. A re- inspection fee of $1.00 will be charged materials and /or workmanship. Date Disapproved ` ' Date (Signed) V.' Cimairnan Member Member .. Council Approved Date kfL 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 $ L /f� ' CIO Amount of Permit $. .,... Zone cubage required Plan Cubage 3 . ... ©t� 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 Sup mleent, and has complied with the p thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed render 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 pcnnit, as are licensed by Miami Shores Village. Rem,uks (Signed) a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- 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 a true. Permit No X' Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE PI 9 Street___ 14 inn get to me well known, Member Member Member ...._ - -.- Disapproved Date making corrections or changes to this application after approval has hero obtained from when such re- inspection is made necessary by improper notice for inspection or faulty BROWARD 7 .792 -2009 DADE 945 -2052 PALM BEACH 734 -4889 JOB # DATE OF FUMIGATION :1 3 o' C, /3 oa t/ / 792-x1.0 TELEPHONE FUMIGATION NOTIFICATION DAY CD FIRM NAME: SOUTHERN FUMIGATORS, INC. 3950 S.W. 6 ST. FORT LAUDERDALE, FL 33312 APPROX. TIME LOCATION OF STRUCTURE / 4 n') / ,S h d ' rC�r S OWNER'S NAME & ADDRESS $601 (// Vl, SO nl / TYPE OF STRUCTURE: C.B.S. )( FRAME RES. BUS. APTS. APPROX. NO. CUBIC FT. c 3' j O C5 NAME OF FUMIGANT VIKANE GAS LENGTH OF FUMIGATION PERIOD 24 HOURS DISTANCE TO NEAREST BUILDING CERTIFIED (OR SPECIAL I.D.) FUMIGATOR IN CHARGE: NAME BOBBY MOOREFIELD 624 -1497 NIGHT FUMIGATION SHALL BE PERFORMED IN STRICT ADHERENCE TO THE FUMIGANT'S REGISTERED LABEL AND FLORIDA STATE BOARD OF HEALTH RULES 1701 -2: NOTIFICATION TO BE RECEIVED NOT LATER THAN THE DAY PRIOR TO THE RELEASE OF THE FUMIGANT BY: COUNTY HEALTH DEPT. FIRE DEPT. OTHER