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RESIDENTIAL DIV.
HILL YORK SAL & SLINK
8115 N.W. 33 ST. MIAMI, FLORIDA 33
PHONE 635-3241
TITLE "
JOB NO. lz
OWNER "\•''. •
ADDRESS
CITY M
DATE r‘iik) nlISCALE l''€)" SHEET OF
DRAWN BY c\ CKD. BY
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Location and legal description of lo`_ to l built on:
Lot -- r .6 . . Block
be sent t _ _ /,. 1
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI Eii--1Jri = $ VI�_..LA1J
f3UILDIN INSPECTION UEPAr2rMEN'
s\PPLICATIJ�J ErJF 3 JILQINE3 p :raMI
Application is hereby made for the approval of the det.,led stateme.:• of the plans and specifications herewith submitted for the build.
Mg or o h r s ructure her r described This r ,?tca';c rs made In compliance and con o•m ty w th the Building Ordinance of Mil
d ii
Shores Vitla�e, r -ora, and a'.1 pro isions of tht Laws , f the Statt c f lh rid. all o d nances �f Mi u Shores Village .end all rules
un B rr.d
regula ,� of the uilding of r.rm Sho. lunge 1 '1 e o� -pl ed with, whether herein specified or riot. A copy of ipprosed
plans and specific_rt, �r must be kc, t bur •d.r.g durin_ progress of tl.e work.
IN
Owner'. Name and Address -_ j
r
Registered Architect and/c1 1 ntineer_ `j -/ x f ( ,( ' /\
Name rd address of 'Seemed contractor .J ,`✓1/. / ':"' t 0 !---,-11.A.
Subdivision ,)/ = -1(
i z s
Street and Number where work is to be done_ )J. 7 6 ' /L..- - _, �.. H
State work to be dor and f - +,r-po e of build': g (by floors) .� f.� �< � � � "i( `-'/-( -
��r' i - / �'
_, <-
The uncle signed appli art for th s bu';ding pc-,nit does her. cc :tif',
of 1 bor under he !Florida \Corkr:en s Co npe•isation At be 1g S ton
and h s compl ed w'tlr he jnov' Ions tnr icof, ,end v.v 1 :« quire s Lela: co, •
in the 'wo k to be p rf riled under th s pern .t and .11 post cr e au- to
or otices as are regwr d by the Act. The u r •gu d agrees to employ , r .
permit as are licensed by D -I an Shores \ it
Remarks_ .
Chairman -- --
Member
Member
Council A.pproN ed Date
Member .
Member
Me-
17 r
Date
-)
� � �_ •
Amount cc. Permit $. �._._ �'
Plan Cubage-'': < °' ( "i 1 i 1 f
Size of Budding Lot .___
NOTE: A charge of •$1.00 will be mule for .caking correct: ms c } .rges t, this ; pplic,•tion
the Planr ng Board
A re- Inspection fee of $1 00 will be Charged when such re- inspection is m.
I - atert:aj-s and /or workmanship.
r rr I
Nr� -l! /!__. S reet. !/ .(Y 1
X) ,' ,
11 ;1 l am , , 2� ; �r' j�'�"
- ,t 1.e under.la-ds and .,ccepts h :s . blig-itio•t,;
C.,; 0 led ter al Laws of Florid, P r an
c oj}
an e frc I :,.1 tr..ctor'. or sib ccntr.c(cr,
-
- stcd f r :,ape k.or, on the site f the wa rk • v
s,
:h : / o ctors, c n •work _u- 1 fn:
d ` :i -'�
•
Before me, the undersigned authority, a notary public, duly authorised to adn•.r-ister oaths nd rake acknc:wledg -imi t
pea; ed
Notary Public State of F1or'da
My G u 1 Ex
fl r rjpte"•.1 1. s 1
rc es a-,t. 1s, improper not cc f.
. and for no other purpose.
New Building _ Remodeling_ ._- _ . Addition i. . _ R pairs . No. of Stcr:es
To be constructed of /... off d / X r] <%�`j2`'�r:� /
t' l Roof Cov ring _ ,� � �� %'! - :1I
Estimated " [al cost of improvements •S_
Zone -ubage required _.
Distance to next nearest bcilding_
Maximum live load to be borne by each flo.ar
hereby surainit all the plans ar )si el i cations it s;4d ririldiny All �tices with refe,nce to the hur!ding and its c•r nstrr.ct on
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%
may
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.. s .i t ' cot,
ni 1. , cci IA 1 .
I ff t e
d r th.s
jr•- _onall. .p
o me well knc•,vn,
and who, being by me first d Iv , w orn, upon oath depor•es and says OW I e is the _
of th abos de c ,bed .stnaction t. • I has care!-illy read the foregoing application, and :hat' .e did sign the same, and i1.1" ct■
therein by him stated ', e tt _e.
Permit No. _ __ ._) _ _ _ . Date /f - ( -. - . _. pearl, Sw i to and Subscribed before me.
Disapproved _ llr e_'
- - ----- -- -- - -- -- _.
(Signed) _ -- - _ __ . -- .) _. ,. .
din,t Inspector
PLANNING BOARD _ __ . ._.DATE
Date
u -'•r�, „ed from
inst. t ,r !L. ty
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