FENCEOwner's Name and Addrcss
State work to be done and purpose of building (by floors) ...
Disapprov
(Signed)
Dui ding Inspee
Citairman
Member
Member
Council Approved
NOTE: A charge of $1.00 will be made for
the Plannir.g Board.
A re-inspection fce of $1.00 will be charged
materials andier workmanship.
MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement ot inc plans and specifications herewith submitted for the build.
in or other structure herein described. This application is madc in compliance and conformity with the Building Ordinance of Miami
Shores VIIagc, 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, whcther herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
11 (L. tikS J:14 R.‘Ar,
Registered Architect and/or Engineer
&QC.
Name and address of licensed contractor - S 15.
" IS 1 n C CAE
Location and legal description of lot to be built on:
Lot... Block r2 5 Subdivision . - — —
Street and Number where work is to be done _S '1 4 S
BUILDING INSPECTION DEPARTMENT
Date
i n
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind qf foundation Roof Covering
Estimated Total cost of improvements $ O! mount 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 employee
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Stumlement,
and has complied with the provisions thereof, and will require similar compliance from all tractors or sub-contr ors employed by hint
in the work to be performed under this permit; and will post or cause to be posted for in
on the site of th rk such public notice
or noticcs as arc required by the Act. The undersigned agrees to employ only such su aj.ra, on •rk to rformed under this
pcnnit, 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
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Date...—...9.2"... 4
No...5.1 -..—. Street—LJ S sr.
-•»-•-•-••••-•••• .............................
and for no other purpose.
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. ' (71. Date Read, Sworn to and Subscribed before me.
to me well known,
Member
Member
Member
Date Disapproved Date
making corrections or changes to this application after approval has been obtained from
when such re-inspection is made necessary by improper notice for inspection or faulty
Application is hereby wade 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.
r . 9s>r
Owner's Name and Address
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
To be constructed of « OL .D Kind of foundation C e e
Estimated Total cost of improvements $
Zone cubage required
Distance to next nearest building
STATE OF FLORIDA,
COUNTY OF DADE. j
peared
Permit No..
Disapproved
(Signed)
APPLICATION FOR BUILDING PERMIT
ss.
Barbara Peterson,
MIAMI SHORES VILLAGE
PLA
BUILDING INSPECTION DEPARTMENT
Date. -... -4 r
Inspector
,3 5 v (7
Date / L - Z7 -
Chairman
Member
Member
Council Approved Date
Date ..._..._ .1 C
No.,�...?
Registered Architect and /or Engineer
Name and address of licensed contractor /
Location and legal description of lot to be built on: /� / �l -ryj / S�1 v� e i ,,�
Lot ? e �! Block 3 Subdivision Ce �- _.. _� ._..! }1 if /" 4c _ 3'?
C..... . i .. ...........e....,,...CTCCCCCt GCC
F- e.vc7^! f_ 8:^v2 61 E'.2 -.._
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit S
Plan Cubage
Size of Building Lot
Roof Covering
:Maximum live load to be borne by each floor
[ 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 t ork such public notice
or notices as . equired by the Act. The undersigned agrees to employ only such su ors, on work t.4 . rformed under this
permit, as nsed by Miami Shor Remarks__
(Signed
(Signed
Read, Sworn to and Subscribed be ore me.
.GGl1 --
ic, State of Florida
Notary,
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the Planning Board.
A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice
materials anti /or workmanship.
•
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally op-
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the. Agent for Edward T. Hittson, owner
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 stag are true.
. My Commission Expires : :.�::, :.2 �� cSrata af.Fixida at a
c^.: ^misaion expires May 17, 197
INC BOARD DATE
Member
Member
Member
Disapproved Date
has been obtained farm
for inspection or faulty
Sfi
r
(
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