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1220 NE 94 St (3)[(fl :A M8 S ._ D ES V8 LLAG E Owner's Name and Address BUILDING INSPECTION DEPARTMENT APPLICATION F R zUIL 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. INS PERMIT 1 / Date._ ay /4 19 -� e � C- Dk Street Registered Architect and /or Engineer.. Q Y v ,4.J Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done / o , 4/ E 7 ' State work to be don and purpose of building (by floors) r 1 rT n F ( . . _ 0 0 _' 1 ,�y _u�' fv__,9c e y 7 r7 v c, /u} e r = L u t' LA) " L' c" e K L 1- - - -- and for no other purpose. pp Permit No �_ 7__l_� Date Disapproved ( Signed) BuildiufQ Insdector Chairman Member Member Council Approved Date New Building Remodeling Addition Repairs To be constructed of Kind of foundation Roof�eri Estimated Total cost of improvements $ ® ® 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 ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on / /.k to be performed under this permit, as are licensed by Miami Shores Village. '/ Remarks (Signed) I LANNING BOARD DATE No. of Stories 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. Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires Member Member Member 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. (Y3 7) • 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.. Ta.s. i - - 7 , 19..5?7 Owner's Name and Address .. M.. 'T=.11.- y m.C4-1" No. 1 07 IS NIE.Street 9 Registered Architect and/or Engineer Name and address of licensed contractor Iset-Atjt,"3 "RoXL.S oc.- 14 C.* . 2-1 o t tSe, fi i 117- Location and legal description of lot to be built on: Lot Street and Number where work is to be done 1 0 7 8 1 1.4 e l 4 4: 617. State work to be done and purpose of building (by floors) ).' La fn.. ••.■/ 1 "i c3). s ra set/ o v p„, and for no other purpose. New Building Remodeling Addition Repairs No. of Stories NM.... To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ - 5 0 c3 . 61) Amount of Permit $ Ea. • c• 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 S 0 * VIA) 1 5 13 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 insp ction ite of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon acto, on w. k to performed under this permit, as are licensed by Miami Shores Village. Remarks (Sign STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized t 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 F- Date 3 k7 Read, Sworn to and Subscribed before me. Disapproved (Signed) ‘..- Chairman Member Member MMMIl SHORES VOLLASE BUILDING INSPECTION DEPA AFFLOCATO N Fon BUM. ate_ 0 Block Subdivision Buil Inspector My Commission Expires PLANNING BOARD Council Approved Date Disapproved 7641ENIT ONG FERMOT . !op nister oaths and take acknowledgments, personally ap- Notary Public, State of Florida .DATE Member Member Member 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 ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ Date PLUMBING ❑ PERMIT N? 8549 Contractor's ROOFING ❑ License No. Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR or BUILDER II BI Work to be performed under this Permit Subdi- vision Sq. Ft. Value of I I Amount of 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 • i 4- / � �� , / ' % ,5f (INSPECTOR) BY In consideration of the issuance to me of this permit agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY