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140 NE 95 StMIAMI SHORES VILLAGE BUILDING INSPECTION 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 building 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 regula- tions 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 the work. Owner's Name and Address_ Registered Architect and /or Engineer Name and address of licensed contractor '�- Location and legal description of lot to be built on: Block_ 7-"'" Su division Street and Number where work is to be done____ State work to be done and purpose of .gilding (by floors) Chairman Member Member Council Approved___ Date NOTE: A charge of $1 the Planning Board. A re- inspection fee of $1 materials and /or workmanship. Buildin: Inspector and for no other purpose. New Building _ Remodeling Addition 1 ....... ""e1 Repairs No. of To be constructed of- tnd of foundation -- - - -__ Roof Covert Estimated Total cost of improvements $ 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 ins do a site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only su h sub 1 dors, on o k to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Sig STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowl /meats, personally appeared 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 therein by him stated are true. Permit No �____— ____ —_ —_ Date. Disapproved . _ Date (Signed) ANNING BOARD DATE Member Member Member Disapproved .00 will be made for making corrections or changes to this application after approval has been obtained from .00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty (over) Date_ , Z o 9- 3 No._ 1 Street 14 _C • Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires to me well known, that all facts _Date 1. General Building Contractor. 2. Plumbing, Heating, Ventilating, Air Conditioning and Gas Fitting. 3. Electrical. 4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators. 5. Excavating, grading, filling and Landscaping. 6. Moving or wrecking. 7. Septic Tank and Drain Field. 8. Brick, Stone, Tile, Cement Block, Concrete and Gypsum. 9. Carpentry, Millwork, Awning and Shutters. 10. Cement, Lime, Plastering, Stucco, Lathing and Cast Stone. 11. Decorating (interior and exterior) , Painting, Waterproofing, Damp- Proofing and Paper- hanging. 12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring snot otherwise specified. 13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors. 14. Roofing, Sheetmetal and Skylights. 15. Solar Water Systems. 16. Well drillers. 17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc. 18. Structural and Reinforcing Iron and Steel. 19. Tile, Terrazzo, Marble, Granite and Cut Stone. 20. Electric Fixtures. 21. Illuminated Signs. 22. Bridge, Bulk- heading, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga- tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work. 23. Every person, firm, co- partnership, Corporation, Association or other organization engaged in the bus- iness of supplying, furnishing or delivering building materials for any construction project within the Village Limits and not having a regularly established and licensed place of business in the Village. LIST OF CONTRACTORS, SUB - CONTRACTORS, ETC. REQUIRING OCCUPATIONAL LICENSES MIAMI SHORES VILLAGE New Building MIAMI SHORES VILLAGE BUILDING INSPECTION 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 building 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 regula- tions 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_ _ Owner's Name and Address 1/ ` `& A 4 f 5 Street—k_f; &e2 Registered Architect and /or Engineer.. Name and address of licensed contractor Location and legal description of lot to be built on: Lot_____ _ _____________ Block_ —_ Subdivision • G� /l. Street and Number where work is to be done____ __ _ �_ State work to be done an purpose of building (by floors) it , 7 r To be constructed of________________ Kind of foundation Roof Covering_ — 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 _ _and for no other purpose. Remodeling_ Addition_ Repairs No. of Stories__ 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. �) J Remarks (Signed) '7 STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Building Inspector My Commission Expires Notary Public, State of Florida PLANNING BOARD____ __DATE Chairman Member Member Member Member Member — Council Approved Date Disapproved 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 (Signed) _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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING PERMIT RECORD MIAMI SHORES VILLAGE FLORIDA DATE APPLICATION Application is hereby made for the approval of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in com- pliance and conformation with the Building Ordinance of the Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all Ordinances of Miami Shores Village, and all rules and regulations of the building Department of Miami Shores Village, shall be complied with, whether specified or not. ARCHITECT 03V,4.4e C NTRA.CTOR Us 1 pp11 LOT /6 d.) J BLK Al SUBDIVISION STREET; NEW a ADDI_T►TON REPAIRS NUMBER OF STORITIE ROOF COST (excluding Architect's fee, landscaping & garage)$ 9 Building to be used for P,n.e/. and no other use. I hereby submit all the plans and specifications for said building. OWNER STATE OF FLORIDA) COUNTY OF DADE ) Signed - M.6.41, . i ariM Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgment, personally appeared to me well known, and who, being by me first duly scorn, upon oath deposes and says that he is the builder of the above described construction, that he has read the foregoing application, and that he did sign the same, and that facts states( by him are true. Read, Sworn and Subscribed before me, Notary Public (Signed) My Commission expires Cubic Feet,77, /Cubic feet required in this Block 4,o C PLANING BOARD Chairma ( Member Member_ -- as, Wit, � i 2 r�l41 - 1,1 3 Secretary Building Inspector Permit No.)2(o Issued to� �/ i s '- 1� Date 0� Electrica1»Permit No. Plumbing Permit No. t 4 d � - 4 7 . "/