739 NE 94 St (3)1
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 build-
ing or other stru ture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores V:llag -, F orida, 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 Miam Shores Village sh 11 be con,plied with whether her in specified cr not. A copy of approve d
plans and specifications must be kept at budding during progress of the work.
Date- . M A 2 -- I _ _ . - - ._ -- , 19 -6 �O
Owners Name and Address ___ __ " fit R l,Y MAN_Q T_ _ __ ____ No.. __Z39 ___ Street__ N , ._ _ 94 " ST •
Registered Architect and /or Engineer __ Q
Name and address of licensed contractor __ __G ERs AlL _ 1 - 1 G.c co _ �_IV C • 71%5_ N , W . 2. (. "_ AV E-
Location and legal description of lot to be built on:
Lot as) _Al W.ZB'oF 21 Block _ 67 __ Subdivision_.___ M1. AM I_ S_ 80 atrs_ - Se_Ct__3 1___ R13 _.__(0_ _P-37 __
Street and Number where work is to be done_ 739 _ ___N -_ - 94 " ,T_.
State work to be done and purpose of building (by floors) ___ —C ha LY_1 ____L_I VI k t f .en_ ce___ _T S 11.07.___
- - - - - -- and for no other purpose.
New Building _ ___ ____ __ .. Remodeling _ Addition_ _. Repairs No. of Stories
To be constructed of _ _ ._ _ _. Kind of foundation _- QQ_ Roof Covering
9,_,S 1313° Estimated Total cost of improvements $ ,S 9,_,S _=1
—° Amount of Permit $__ ex)
plan Cubage
_Size of Building Lot--- ---- - -- -- --
Zone cubage required_
Distance to next nearest b u i l d i n g
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 - !�! !��n'ItL _ t + C v I N 5. 7( ci3S W. AYE:
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 inspe tion on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subco actors, on • be performed under this
permit, as are licensed by Miai::i 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 -
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. ___ _ _ _ __ _..__ _ _ . __ -.__ Date.
Disapproved _ _ _ Date _
( Signed) -
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector 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 -in ect`on 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.
Ca'
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N 9 ,z /A j77-
93
68
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711
BUILDING
ELECTRICAL
PLUMBING
ROOFING
PERMIT
Owner of
Building • rt
Architect
Contractor
or Builder
Legal Lot
Description 111
MIAMI SHORES VILLAGE, FLORIDA
,r
Address of '
Building P j
N° 7 319
DATE.
Contractor's -✓
License No.
Work to be performed under this Permit
A SA
Value of Amount of `'
Project $ ig - Permit $ f
�
19
Subdi-
vision
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 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 or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
CONTRACTOR OR BUILDER
t
Signed { ` ; . INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in com fiance with all ordinances arid regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the prop authorities of Miami Shores Village. In no
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
ABBOT