ROOFINGDisapproved
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Appheation is hereby ma rk ma rk fo the approval of the detailed statcurrnt or ore plans and specifications herewith submitted for the build
inc or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
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 progreu of the work.
January 16,
Date ..._...._.._ ...._.__....
Ross Fryer 758 N E. 7 g7 E £Fh Sf.
Owner's "tame and Address ... ... No. . Street
Registered Architect and /or Engineer
Name and address of licensed contractor Obenour Roofing CO.
Location and legal description of lot to / ,...! /.
be b ilt on:
Lot _h .111 Block. 67 Subdivision.
Street and Number where work is to be done 758 N.E. 9
State work to be done and purpose of building (by floors) __......_..._.._....
Reroof entire residence with new white tile I �
ASi 'NXXXX...._....._...._.._. sqs and for no other purpose.
New Building Rcmodch reroof
Remodeling. Addition Repairs No. of Storiet
To be constructed o r -43, 1 - 90 L . i WOO
... _..... nd of foundation Roof / C � ovcrfng ................. .
Estimated Total cost of improvements $ .... 4-t1.0.�1... P� �^ Amount of Permit S. 14sf Ord
Zone cubage required .Plan Cubage
Distance .to next nearest building. Size of Building Lot
Maximum live load to be borne by each floor
Date
ii . LW d /f90
Miami 'Shores
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. ..... 7357 N.W. Miami Ct. Miami, FL 33150
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 Compensatiuu Act, being Section 5966, Compiled General Laws of Florida, Permanent Srippleuient.
and has complied ssith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
i 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 arc required by the Act. The undersigned agrees to employ only such su• •ntractors, on wog be performe u =er this
pcnnit, as are licensed by Miami Shores Village.
Remarks (Signed
Ors,
STATE OF FLORIDA,
C OF DADE. ( ss.
Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, persortalij• ap
peared George Obenour, Jr.
to me wen 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 ap ' cation, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No N l 1 4 - � Date .._.,.) - t.14 I V�
a worn / o and Stsbse
87
Notary Public, State of Florida
i
Building Inspector • My Commission Er
PLANNING BOARD
OF FLORIDA
M Y` C OMMISSION EXPIRES FEB. IL:
D
Chairman ....... Member
\]ember _. Member ........... . ...... _..._..... -- ..._ -
Mcmber _....._...... Member �.._...._
Council Approved Date Disapproved Date
NOTE A cli.urge of $1.00 will be nude for making corrections or changes to this application after approval has been obtained from
the ,'Lenoir,;; 1:o.rrd.
A rr iust,ei Lion fce of 51.00 will be charged when such re- inspection ix made necessary by Improper notice for inspection or faulty
materials and /or workmanship.