1006 NE 97 St (5)Owner's Name and Address _ _
Registered Architect and /or Engineer
Name and address of licensed contractor l41.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
jill■ 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 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.
Location and legal description of lot to be built on:
Lot /I Block _// SSuubdi on
si
Street and Number where work is to be done /OD __ a /�
State work to be done and purpose of_ , building (by floors )_
_
Estimated Total cost of improvements $___ O Oa O. Q O
Date
2?
5 4,4"./e ....._ /
and for no other purpose.
Streeted
, 19 Sz
New Building____ '--'"-- Remodeling Addition — Repairs No. of Stories
To be constructed of __ Kind of foundation G'HA %� Roof C vering -7
Amount of Permit $ Z 2 eke.
Zone cubage required _ _Plan Cubage 3 2 Z 4. 3
Distance to next nearest buildi .2d_____ 1`• Size of Building Lot 144 X___le).r�
Maximum live load to be borne by each floor__
" CI - - -
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 ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such sub ntractors, on wo to be perfgrm4 under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
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 e first duly sworn, upon ath deposes and sa's that he is the
of the above descr ed construction, that he as carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stat d are true.
Permit No ----- __ Date $k. _/ Read, Sworn to and Subscribed before me.
Disapproved _ 1 _ Dafe
III i 'r Notary Public, State of Florida
(Signed)
Building Inspectgl r My Commission Expires
4 NNIN OARD 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- 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.
Permit No.)._
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 work.
Owners Name and Address k
Registered Architect and /or Engineer________________
Easplorissemaitaboris et), r "
Nam
Location and Legal Description Lot
Street and Number where work is to be performed —No 4 1 ���
State work to be performed and purpose) _
New Building _ .___.___ Remodeling —___ _____ Addition__- _____._.__ Repairs__
Amount of Permit $___
A
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PERMIT
7 o G: 'r'iGd \ d f " � ._� , . No. /0 I ..____ Street- --
Block
Date.
Street__
y t
Stre -
Size Septic Tank.. -__________________________.___ -Type of Tank
Feet of Drain Tile._.__.._ -_ .___ -_ -_- ___Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well..____ —_ _______ _ __. Size of Soakage Pit
(Signed)_
Capacity Gals
Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this build4pg 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 5988, Compiled General Laws of Florida Pennanent Supplement, and has com-
plied 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 tEe Act. The undersigned agrees to employ only such sub- contractors, n work, to ,perform under this permit, as are
licensed by Miami Shores Village.
F / , l
( Signed
STATE OF FLORIDA,
COUNTY OF DADE.
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and/or worlmnanahip.
CLOlR!
BATH
um;
SHOWER!
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINAL!
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
Lam'
CHECK
SEPTIC
TANK
SEWER
CONK.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL.
COMM
Lt.T
!_
CHECK
Permit No.)._
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 work.
Owners Name and Address k
Registered Architect and /or Engineer________________
Easplorissemaitaboris et), r "
Nam
Location and Legal Description Lot
Street and Number where work is to be performed —No 4 1 ���
State work to be performed and purpose) _
New Building _ .___.___ Remodeling —___ _____ Addition__- _____._.__ Repairs__
Amount of Permit $___
A
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PERMIT
7 o G: 'r'iGd \ d f " � ._� , . No. /0 I ..____ Street- --
Block
Date.
Street__
y t
Stre -
Size Septic Tank.. -__________________________.___ -Type of Tank
Feet of Drain Tile._.__.._ -_ .___ -_ -_- ___Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well..____ —_ _______ _ __. Size of Soakage Pit
(Signed)_
Capacity Gals
Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this build4pg 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 5988, Compiled General Laws of Florida Pennanent Supplement, and has com-
plied 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 tEe Act. The undersigned agrees to employ only such sub- contractors, n work, to ,perform under this permit, as are
licensed by Miami Shores Village.
F / , l
( Signed
STATE OF FLORIDA,
COUNTY OF DADE.
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and/or worlmnanahip.
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.
Owner's Name and Address
Registered Architect and/or Engineer
Name and address of licensed contractor
teliN K 44FOS
6, l7►` (3I S r D
Location and legal description of lot to be ui o n:
Lot /1 Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors), state exterior colors (submit samples)
and for no other purpose.
New Building Remodeling Addition Repairs No of Stories
To be constructed of Kin c} oundation Roof Covering 41 Estimated Total cost of improvements 5 1 fe O t ' Nio Amount of Permit 5 60
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 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 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 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 ermit: 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 o employ only such s o tractors. on woy to be performed
under this permit. 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 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 fgregoing pplication, and that he did sign the same. and that all facts therein by him stated are true.
Permit No. Date! Read. Sworn to and Subscribed before me.
Disapproved
Date
De As Sb-s iM
Date A J/ 19 e
No. f /O ll Stri( �/ J
/ 4c 17 / 0R.1 VE tc//'
70 S
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 525.00 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 525.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and or workmanship.
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