960 NE 92 St (9)F) )
Owner's Name and Address
MIAMI SHORES VILLAGE
= vELtN
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR ELUILDING 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.
Date S/ , 19
No 9 G O Street 5
Registered Architect and /or Engineer
PA NCZ Co . } l� , c_ 61 0 W. 2 5 7H >4 1 qLEWt
Name and address of licensed contractor 1 ik-/ L L ' M3
Location and legal description of lot to be built on:
Lot_________ Block Subdivision
Street and Number where work is to be done 9 (a 0 N t^ g Z � + D 5 •T
� A�c
State work to be done and purpose of building (by floors)____ v D R'v 4 1", 1 1 T Y � e 1 n 'l '
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 $ 3 50 ____ _Amount of Permit $
Zone cubage required _.________flan 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 5988, 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 • spection o ' the site f the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su....ntractorsJ on work be performed under this
permit, 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 true.
Permit No 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description II Bl
N? 7828
DATE. 19
Contractor's
License No. t
Work to be performed under this Permit
Subdi-
vision
Address of '' Value of I Amount of
Building Project $ II Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed: INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances arid regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ao
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY AUTHORITY
AC3OT s4'
Estimated Total cost of improvements $
Zone cubage required_
Distance to next nearest building
Disapproved
( Signed)
/V°
Building Inspector
Oo0
0
Chairman
Member
Member
Council Approved ___ Date
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
Date
i
MIAMI SHO EIS VILLAGE
BUILDING INSPEC 19i1V DEPARTMENT
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.
State work to be done and purpose of building (by floors )_L /_
J2' I1 ! A3
Still 7
Owner's Name and Address_ nail 1_'?,,5 4.//.7_1 �7 4 �N4 No 0 Street- NE
/!
Registered Architect and /or Engineer 51�� 5 AAA/ AA .1
Name and address of licensed contractor _ 4 T1 I/ • 71/6 S
Location and legal description of lot to be built on: // /
Lot ___�� o / Block Subdivisian_L7 e� /_l'_D K 6211 L'�1 '___
Street and Number where work is to be done
CPI41 �_s
and for no other purpose.
New Building____ Remodeling Additional /"/_le, l?eARepairs 1---- No. of Stories
To be constructed of Kind of foundation Roof Covering
Amount of Permit $
_,__plan Cubage _
_Size of Building Lot .,7J
Maximum live load to be borne by each floor
1 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 such subcontractors, on ork to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks-- (Signed)__
STATE OF FLORIDA, D
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 �_/_y Date (— ' Read, Sworn to and Subscribed before me.
NG BOARD DATE
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
Disapproved Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper n• tiee for inspection or faulty
a