561 NE 95 St (2)STATE OF FLORIDA,
COUNTY OF DADE.
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.
Owner's Name and Address Mil,/
Registered Architect and /or Engineer
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
State work to be done and purpose of building (by floors)
SS.
MIAMI SHORES VILLAGE
Date
Date
BUILDING INSPECTION DEPARTMENT
Date...
and for no
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind foundation Roof Covering
Estimated Total cost of improvements $_.._l.(1: .:. Amount of Permit $_.0 f1
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 pennit 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, Pennanent 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). NYC' 4x
d
)(r+(
4
(< r, wee f f 1..+✓` ,( • 0/ A. E /y '... d"' G #4s
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 Nod 3 f
Disapproved
t
(Signed) w
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
other purpose.
uilding Inspe 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.
MIAMI SHORES VILLAGE. FLORIDA v
BUILDING ❑
ELECTRICAL ❑ DATF ¢ " p 195
PLUMBING ❑
ROOFING ❑
Owner of
Building
Architect
'Contractor �
or Builder
'Legal Lot
Description � Bl
Address of v)
Building
l.:
f 1 i i Pr
In consideration of the issuance to me
pertaining thereto and in strict conformity with
cepting this permit I assume responsibility for
4,
CONTRACTOR OR BUILDER
PERMIT N° 5310
73
Work to be performed under this Permit
•
Contractor's / 3
License No.
Subdi-
vision
�t� a
Value of "' Amount of
Project $ 11 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 application
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 kno edge of thee. ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the s atements or spec! 'cations and at he assu`nteg responsibility for work
done by his agents, servants or employees. `
Signed. L3-" ''' - " °i
INSPECTOR
•
of this permit I agree to perform the work covered here der in compliance with all ordinances regulations
the plans, drawings, statements or specifications submitt to the proper authorities of Miami Shores Village. In ac.
all work done by either, myself, my agent, servant or employee.
BY _ AUTHORITY
6 40"
Owner's Name and Address
Registered Architect and /or Engineer
State work to be done
Permit No
Disapproved
(Signed) 442
Date.
Build n Inspector
Chairman
Member
Member ...... _.._._.... - ._.......
Council Approved
MIAMI SHORES VILLAGE
PLA
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 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.
-J8 _/ /lei,
Date
purpose of buil (by floors)
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re fee of $1.00 will be charged
materials and /or workmanship.
Name and address of licensed contractor
Location and legal description of lot to be built on:: ��
Lot �` el 2 / Block S - 7 Subdivision / re.-r c2
Street and Number where work is to be done .5 / ` 9 S 7 J 7 .
and for no other purpose.
New Building Remodeling Addition Repair No. of Stories
To be constructed of Kind of foundation .. Roof Cove 5 ...�
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 noti
or notices as are required by the Act. The undersigned agrees to employ only such su ctors, on rk t be je rforrj4 under
pennit, 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
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 tru
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
INC BOARD DATE
Member
Member
Member ...._
Date Disapproved
Date..._ 7- 'Z _ _._ ,19 ��
No S6 / tiiStr jt
}T!t1'!••Tt••••!Tt... t.M
or changes to this application after approval
�
to me well known,
Date
has kern obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty