920 NE 95 St (6)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 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.
19 YO
ner's Name and Address 7197.' XPi// Y P °1<lg No Street
Registered Architect anchor Engineer /10 i‹./ Qi
/Name and address of licensed contractor el ,Aa7.e /',�� S
Location and legal description of lot to be built on: J
Q y /
Lot / Block Subdivision 2 � i-Aed // Jo 4b ®/ /� 0.0/0i reet and Number where work is to be done �� e N
L h < tate work to be done and purpose of (by floors). state exterior colors (submit samples) s ! "JC/ S f
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
stimated Total cost of improvements S loo - Amount of Permit $
' 31010
Zone cubage required TTT Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to
Disapproved 0 � �"� Date
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 he provisions thereof .P ill require similar
compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit: will post • .:use b •osted for inspection
on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to emplo ly such .co• ac .rs .n work to be performed
under this permit. as are licensed by Miami Shores Village.
Remarks (Signed �_
STATE OF FLORIDA Ev
COUNTY OF DADE. } ss.
Before me. the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared
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. .6F�v / Date �/ Read. Sworn to and Subscribed before me.
Notary Public. State of Florida
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anchor workmanship.
■, Z NIFIVIIMIWINTIMPIIIIIIMPIrlregrrus
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cam,
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.
STATE OF FLORIDA,
COUNTY OF DADE. j
Disapproved _ - --
(Signed)
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor tr r/R0 fIl V "V? 6 " • 91 N ( - 4 - ) /64/ 57'
Location and legal description of lot to be built on:
Lot Block �j Subdivision q c
Street and Number where work is to be done L_ -_
State work to be done and purpose of building (by floors) U J F'
Date
Chairman
Member
Member
Council Approved Date
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of 51.00 will be charged
materials and /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date_ ____ C
No
LANNING BOARD DATE
2
, 19 �`+
Street / F 4 ? 557
K3 pi? eSe r7 DR(Ve Ge4•/
---- - - - - -- and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
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 ----- - - -
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 public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perfo ed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) (-2/0 fi�`�4it
. �.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
Read, Sworn to and Subscribed before me.
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.___l_ 7 /
Notary Public, State of Florida
Building Inspe.+or My Commission Expires
Member
Member
Member
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
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA a ��
Date 19 _
ELECTRICAL ❑
PLUMBING ❑ PERMIT N? 10677 Contractor's o c
ROOFING ❑ License No.
❑ Work to be performed under this Permit
Owner of
Building L f Q (! .�
Architect
Contractor• V A y r �� 1. ` N C.,
or Builder
Legal Lot
Description 11 BI
'T
Address of 9 CI F-I ` 9,
B
f
uilding
CONTRACTOR or BUILDER
�. a t r ,_ , �`. ?its S• �/
Subdi-
vision
Sq Ft.
Value of
Project
MO .-,
BY AUTHORITY
11 Amount of
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 applica-
tion 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 at—we assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plan ti drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, se nt r eteyioyees. ('
Signed �` " t ' hI' (IN CTOR) BY
In consideration of the issuance to me of this permit I #ee to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans dr• : ngs, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this perm' I assume } responsibil li ity for all Dr done by either, myself, my agent, servant or employee.