925 NE 95 St (3)MOQMO SHOO VOLLA E
BUILDING INSPECTION •EPA TIMENT
0
Remodeling . ...._Q-
Addition.
A PLOCATD N Fo ° LDOND PER MOT
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 1Buildin$ 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 he complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
, 4,,P •--J
P Date vi.'" .
l,
Owner's Name and Address _ /9 - . - -- . -- 1. 7°-- 1 7ii - T / No / /'•r Street --- 1''1...7.__f- : i
Registered Architect and /or Engineer ... _- _. .,.. ''4 - / f'�, .�_ - '! i
Name and address of licensed contractor A L '' fl/ i e _.___t�J J (gJJA!Y) (f". "v !'lV
Location and legal description of lot to be built on:
Lot Block Subdivision rV
Street and Number where work is to be done ,+ r 2 7 — � ,
1
State work be done and purpose of build' g (by floors) l l is 4 / f /%( F f - '
and for no other purpose.
New Building
To be constructed of Kind of foundation ,f)0 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
Repairs
No. of Stories ..
l51 °'
I hereby sujrmit all the pl n4. --and sppqfications.fyr Said building. All otices v);.ith reference to the building and its cons rocjio knay ,
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 rovisions thereof, and vvill require similar e from all ntractors or sub-contractors employed by him
permit, as are licensed by Miami Shores Village.
or notices as arc required by the Act. The undersigned agrees to employ only such su
ed for in tic on the site of the wo such public notice
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
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 13oard.
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.
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 sane, and that all facts
therein by him stated are true.
Permit No 7 1 ? 7 Date ��Q Q Read, Sworn to and Subscribed before me.
Disapproved / __ Date
_ Notary Public, State of Florida
(Signed) -
ing Inspector My Commission Expires
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE j 195
PLUMBING ❑ PERMIT N9 7777
ROOFING . ❑
7! >. fr a NI Work to be performed under this Permit
Owner of
Building ' /1 A.-14 -14 / E:' e E
Architect
•.
Contractor
or Builder , t' - t --t -1 t • { en r I: e 's V •
Legal Lot II BI.
Description
Address of
Building
This permit is granted to the contractor or builder named above to conatriuct 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 apprpved 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 arse 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 knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings tor jp the statements or se'r ificajpns and that he assumes responsibility for work
done by his agents, servants or employees. t•
r,
Signed • rf , / C . • BY
I SPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements oi s ecifications submit to the proper authorities of Miami Shores Village.
In accepting tljpermit I assume responsibility for all work done by eith (, myee my agent, serva or employee.
/ .A. 7
/
•
• /
CONTRACTOR OR BUILDER
Subdi-
vision
Sq. Ft
Value of
Project $
.� y / gy i M' f'` �:
BY
Contractor's
License No
Amt. of
Permit $
AUTHORITY
17