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FENCEPR �0YEL �� "" Name _ j Q g I Address @/ g 4/E-102 J7 Home Telephone �-0ni _ / ° �,_S r 2, 7 Business Telephone & /61-- /- ,..?- l J Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami'Shores Village: Step I. Job Address: • Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. A PPLICATION /52O(0'of*• 00,0 Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other It g 9-2 5 Address Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. 5 PERMIT APPLICATION 1 City ��// DD Description of Work (Z/® e, Ar-pAcE Zoning Square Feet Q�/�y -r� Value of Work (2 , ,C1C)BIdg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. State 3 3J33 . 1V0OI Linear Feet Units Floors ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 I1'IPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. 1. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1'' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choostng ..' S ntractor. STA r l A ` �g; • 4 . 7 .: TY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE : Ign.��re • '� wn — Signature of Contractor / Qualifier 41 le A ArA114 Sworn to and subscribed before me this SEAL: I D Personally known 1P pV6 ANGELA NIBECKER 0 COMMISSION NUMBER cr) _ l ° a CC786697 4.- MY COMMISSION EXPIRES OF F.O NOV. 15,2002 2 OR, Produced identification Type of Identification Produced: Print Name Signature of Notary Public - State of Florida SEAL: • ,. PERMIT APPLICATION day of Personally known OR, Produced Identification Type of Identification Produced: Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 1/25/2002 Applicant: RAFAEL Owner: DURAN Contractor Local Phone: Parcel # 1132060060080 Job Address: 918 NE 92 ST Fees: FEE2002 -453 FEE2002 -454 FEE2002 -455 Permit Status: Approved Description Amount Building Permit Application Fe$60.00 CCF Notary Fee Total Fees: Building Permit Permit Number: Address: Cellular: DURAN RAFAEL $1.20 $5.00 $66.20 BP2002 -155 Legal Description: AMD PL GOLDEN GATE PK PB 7 -54 LOT 10 & N7FT OF LOT 9 IN BLK 1 OF Permit Expiration: 7/24/2002 Construction Value: $1,400.00 Work: GATE & REPLACE CHAINLINK TO WOOD FENCE 5 ' FT HIGH (OWNER BUILDER PERMIT) If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. fee is $50.00, which must be paid in advance before call' This Permit is granted to the contractor or builder named above to const ordinances pertaining thereto and with the understanding that the work will and approved by the proper municipal authorities. This Permit may be rev authorization. A further condition upon which this permit is granted is the t ordinances and regulations pertaining to the work covered hereby whether by his agents, servants or employees. Signed: (INSPECTOI In consideration of the issuance to me of this permit, I agree to perform with the plans, drawings, statements or specifications submitted to the prc myself, my agent, servants or employes. Signed: (Con RAFAEL T. DURAN 918 N.E. 92 ST. g MIAMI SHORES, FL 33138 Pray to the U // Order rr rN 011, 1 0 1 Eastern Tina fcial Federal Credit Union® Quality Service Starts Herel Merchant Verflicttion 954 04 - _ i For 1: 26 7080 1 7 71: 50 300 78 60 qfl 1 r.11. Page 1 of 1 Total Fees: $66.20 Total Receipts: $65.60 Re- inspection 1934 D 24 L .L1 . 8011/2870 Dollars B �... nr 5'-0' MAX 7-0" Owner's Side - I' -0"-- 4 WOOD FENQES• ••• ••• • • • • • • • • • • • • • • . • • • • • •••• • • • • • • • • • • • • • • • - • • • ••• • • • • ••• 5'-0" Concurred • • • • • • • • •• • • •••• • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • ••• ••• •• • • •• • • • •• • •• • 'No • • • • • • • 2915 Fences • •••• • •• • •• • • • • • ••• •• 4' -0" High or Less = 6' -0" O.C. 5' -0" High or Less = 5' -0" O.C. 2915.1 Wood fences, so located on a property that by zoning regulations they cannot be used as a wall of a building, shall be constructed to meet the following minimum specifications. k 0 -7 (a) Fences not exceeding 5 feet in height shell be constructed to meet the following minimum requirements: from nominal 4 inch by 4 inch by 8 feet -0 inch long posts spaced 5 fee' -0 inches on centers, having a fiber stress of 1200 p.s.i. in bending, and shall be embedded 2 feet -0 inches into a concrete footing 1 fcot -0 inches in diameter and 3 feet -0 inches deep. Other components shall be designed to comply with .the provisions of this Chapter and Chapter 23. (b) Fences not exceeding 5 feet and 4 feet in height respectively shall be constructed as provided in paragrap'i 2915.1 (a) herein, except that the spacing of posts may be increased to 5 feet -0 inches and 6 feet -0 inches on centers for these heights. KUM 1? WAIL BOUNDARY SURVEY 1 •- - COE4C: - t/ t UTtL.I - 0 c to. 5`, ..T - FAY f :).0:;•(0 4*. 5 -d ni v- GJ i;. -4,14,11 .v _CM) J t / ' Z " J ' woaA tQt 2' o It Property Address: 918 NE 92 Street Miami Shores, FL 33138 � Survey Number: G -23826 /aa • • y'Inl Legal Description : Al KGElyD •1 f M • • .NAIL • • �` • M • •PRI7PERTV CORNER •• VI • • Rit • ••• i 1 M FELD MEASURED C CALCULATED a ?ft a aE EA R R r • I i La; vow/a-a •• S • ••=. . alb; FAR romp NRON ROO F.LP. • r0UN0 IRON PIPE • N/D• a W1R T a D I S1C• crilrA . •• is • DC •O18AM1ALBE EAST NO1T JG • .. E MI 1 ••• • • iOYMD, • • • • PLAT VII grown ASFWALT _ soccer/ tilArg 0.911 1• ..A 114, 111111111 --,Y.� • �" • w* 111 ( LCCA u fcaP -T TO Lot 10 of GOLDEN GATE PARK, according to the Plat therei f, as recorded in Plat Book 7, at page 54, of the Public Records of Dade County, Florida, and the North 7 fEet of Lot 9, Block 1 of BISCAYNE RIDGE, according to the Plat thereof as recorded n Plat Book 39, at Page 41, of the Public Records of Lade County, Florida. Community Number: 120635 Panel: 0093 Suffix: J F.I.R.M. Date: 3/2/94 Flood Zone: X' Field Work: 5/1/00 Completed: 5/2/00 Certified To: Rafael Duran; Richard Gonzalez, P.A.; Attorney's Title Insurance Funcl Inc.; Suntrust Mortgage, Inc., its successors and/or assigns. n D.B. 0. QK 0/W ESAR EL Fr. FCIL F.P.K L L.A.E. ALK ALES Q aka. P.CP. P.RK PC ABM PS P.O.S. P.O.0 P.O.L. P.0 P.R.0 P. r. R ROE. SLIL SAT T.B.L. T:aa TYP. 10.50 • CENTRAL ANGLE/DELTA DEED BOOK DESCRIPTION OR DEED DRILL HOLE DRIVENAY EASEMENT - ELEVATION ERODED FLOOR FOND CONCRETE MONUMENT FOUND PARKER.-KALON NAIL LENGTH WITTED ACCESS EASEMENT NOT 70 SCALE OFFICIAL RECORDS OFFICIAL RECORDS BOOK PERMANENT CONTROL POINT PERMANENT REFERENCE MONUMENT PAGE PAVEMENT PLAT DOM PONT OF BECIN/N G POINT OF CEIM Ep4ca 147 POUT ON LAVE PONT OF CURVATURE PONT OF REVERSE CURVE PONT OF rANCEHCY RADIUS (BANAL) ROOF OVERHANG EASEMENT SET NON ROD t CAP SID•IYALK • TEMPORARY BENCH AMRK TOP OF DANK TYPICAL M/7NESS CONKR E)4STING ELEVATION Y • P.P. POTTER POLE Tx TRANSFORMER CATy. CABLE RISER 1R*L LkMIER METER TEL TELEPHONE FAWWIES COVERED AREA RA BEARING REFERENCE CH CHORD RAD RADIAL . N.R NON RADIAL A/r AR COMMONER Rai BENCH MARY! Ca CATCH BASIN C. CALCIRA7ED (jFNERAL NQTES• 1) LEGAL DEiORP710N t D BY OTHERS 2) THE LANDS SHORN HEREON IIERE NOT ABSTRACTED FOR EASEMENTS 3) OR OTHER RECORDED ENCLA'BERAMCES NOT SHOWN ON THE PEAK UNDERGROUND PORTIONS OF F007V4GS. FOUNDATIONS OR OTHER IMPROVEMENTS WERE NOT LOCATED 4) MALL TIES ARE 70 THE FACE OF THE NALL. 5) NOT VALID LNVLES5 SEALED.1I7)4 DIE EMBOSSED SURVEYORS SEAL_ 6) ONLY VISSLE ENCROACHMENTS . LOCATED 7) N0 1OE4W7CATION FOUND O#.PROgERTr aaaNERS LRYLESS NOTED. B) DWENSIO.LS 940MN ARE PEAT *ND MEASURED UNLESS OTNLERIMSE SNOW 9) FENCE 0098.RSHIP N07 OVERARMED to) ELEVATIONS sr SHOWN ARE BASED. CAPON N.GV.D. 1N LE55 OTHERNSE N07Ea /1) BEARINGS REFERENCED 10 LANE 1401ED AS DR. I HEREBY URT.fv THAT NTS 'BOUNDARY Sim CY TS A TRUE AND CORRECT REPRESENTATION OF A SI8bEY PREPARED UNDER 1!f DOTEC1 -4 sAG7VE0 STATE OF FLORHAA RALPH SW:Raton REGISTERED LAND 0LRYEY IT ND 3411 STONED i a YOE a YMCAS. SIC EO Re s1ERED LANG SURVEYOR Na NOS STATE OF FLORIDA STATE OF TENNESSEE JUKES E MCALEER RfrS7EREO LAND AARW O9 Na 7133 THIS &WW Y K *TENDED FOR MORTGAGE OR PL1 W CE PIURPOSES ONLY. EXauO9fL Y' ' FDYR T765 ItSE Br THOSE 10 NNW 47 IS comma 7765 SuMer TS NOT 70 BE USED FOR CONSTRLC77OM PERMITTING DE9G71 OR ANY OTHER USE M11NOUr ALE ROTTEN CONSENT OF FIRST FNANCQAL SUMMITS. AC Firs Financial Surireyors, u60 S.W. 92 meet Suite 204 Fb1da 33156 13151271 -3653 Vas 13031271 -2099 2140 ��� s 202 (561) 646.4820 Fax (541) 6404576 363 Adis Avenue, Saito 3 Oviedo, Florida 32765 (407) 977 -7010 Fax (467) 977 -7020 1187 Vultee Boulevard Naskoille,'haansee 37217 (615) 3664432 Fax (615) 366 - 8477 AND AFFILIATED COMPANIES L.B. 6387 (FLORIDA) Natieawlde 1400 - 787.8266 Fax: 1400- 7874260 ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16 -20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYI'E A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well IIce Maker Pump, Sump Utility - Water Dishwasher 1 ndirect Wastes elay 9': epair Vacuum Pump Disposal 1<nterceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum (Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) Code Enforcement Fine Zonin • eview ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE ° (New Construction) ❑ OTHER (Specify & Attach) $ (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: SECTION Zonin Electrical Mechanical Plumbing Fire Public Works Structural Building Official ATE ( sq.ft. = x/1000 x ¢.60) (¢.005 /sq.ft.) . ^ PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ , — 3 ; to V ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com PERMIT APPLICATION FOR MIAMI SHORES VILLAGE I 1� V Date /GG i Job Address � � Tax Folio Legal Description Owner/Lessee / Tenant Owner's Address '(7 UE / 'T Contractin Co. 66(.0A Address Qualifier SS# State # Municipal # Competency # Address OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and thata construction and zoning. Furthermore, I authorize the above -named contractor t6 do Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date Notary My Commission Expires: FEES: PERMIT APPROVED: Zoning Mechanical RADON i1 Nozbj puilding ,1 C.C.F. 60 Historically Designated: Yes No My ,.mmission NOTARY Electrical Master Permit # mar Phone 3 • '7 Square Ft. Estimated Cost (value) 't,% 11 actor or Ot i M1MM Phone Ins. Co. — 76 c Architect/Engineer Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN FENC SIGN WORK DESCRIPTION AP ' — S / " ic/& /G //7 4' cz WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. Contractor or O er, ui work will be done in compliance with all applicable laws regulating oik stated. Date ( 3 Date BOND TOTAL DUE ( Plumbmg Structural Engineer 5'-O" MAX 2'-0" 4 O A O 4 I = I =11 =111= 1 1 1 1 =11 -111 111 —I' -0", 4" X 4" Wood post 2" X 4" Wood kali I "X6 "orI "X8" Wood !' Ickets Concrete 4 4 4 0 WOOD FENCES 3' -0 2915 Fences Wood Posts 4' -0" High or Less = 6' -0" O.C. 5' -0" High or Less = 5' -0" O.C. 2915.1 Wood fences, so located on a property that by zoning regulations they cannot be used as a wall of a building, shall be constructed to meet the following minimum specifications. (a) Fences not exceeding 5 feet in height shall be constructed to meet the following minimum requirements: from nominal 4 inch by 4 inch by 8 feet -0 inch long posts spaced 5 feet -0 inches on centers, having a fiber stress of 1200 p.s.i. in bending, and shall be embedded 2 feet -0 inches into a concrete footing 1 foot -0 inches in diameter and 3 feet -0 inches deep. Other components shall be designed to comply with the provisions of this Chapter and Chapter 23. (b) Fences not exceeding 5 feet and 4 feet in height respectively shall be constructed as provided in paragraph 2915.1 (a) herein, except that the spacing of posts may be increased to 5 feet -0 inches and 6 feet -0 inches on centers for these heights. FL.vemE.NIT Fax..lot:?vu. - f.ii.S&IL I t0.5 rA.Y. faT . -- c/ 2 `j BOUNDARY SURVEY •,, ) Lot 10 Plat the the Pul North 2 accordi 39, at 1 Florida Comm Suffix: Field R Certifie Rafael Insuran success Propert 918 NE Miami Survey , t5 3.5! ♦ ` TRIANGLE OF VISIBILITY: All driveway /roadway entrances and exits shall be constructed so that vehicles may enter and exit without posing danger to occupants, pedestrians, or other vehicles. Structures and landscaping shall not obscure vision above 2.5' within the triangle commencing at the point of intersection . of the driveway and sidewalk/right -of -way for a distance of 10' along the driveway and 10' along the right -of way. May 2000 • RESIDENTIAL FENCE/ WALL TANDARDS- INTERIOR LOT REAR AND SIDE YARD : 5' HEIGHT LIMIT ♦\ ` FRONT AND SIDE YARD : ♦\ „� ��a �� 3.5' HEIGHT LIMIT All walls and fences \ r \ in the front yard require • ♦, 07 ; ' 25 � approval by the Planning and Zoning Board. Sidewalk Swale Str ©el PROPERTY LINES 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____ 2 C , vjl Location and 1e 1 description of lot to be built on: Lot Block STATE OF FLORIDA, COUNTY OF DADE. BUILDING INSPECTION DEPARTMENT }ss. MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT WA2 19 Fe �� No � Street N f T Street and Number where work is to be done State work to be done and purpose of building (by floors) Jiro' fe,gc - / ,V.rP'N 'cic lJ c A6 _De co AC, and for no other purpose. New Building Remodeling Addition Repairs No. of Stories 1 To be constructed of Kind of foundation Roof Covering _ Estimated Total cost of improvements $ `' Amount of Permit $ 1� 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 e ja and spec' ' ations for said building. All notices with reference to the building and its construction may, be sent to // �� 4 °, j /✓� / 7 £1__� Ci 7 y Disapproved Date_ ( Signed) "1-A • Subdivision rif 2 Date /l A C'/f Riiv 4 //vAl Notary Public, State of Florida � 44 )-1 NW /7?JT t .90 k (7' A'1iFit1 c;; / 44 c 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) ' 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 7 _L 2 Date ` ( `1 Read, Sworn to and Subscribed before me. Building Inspect;? r 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.