PAINTBUILDING
ELECTRICAL
PLUMBING
ROOFING
❑ PERMIT N°
CONTRACTOR OR BUILDER
MIAMI SHORES
Owner of ,
Building '
Architect
Contractor
or Builder
Legal Lot
Description B'
Address of
Building �
VILLAGE. FLORIDA
6442
.4-z .
DATE
195
Contractor's
License No.
Work to be performed under this Permit
Subdi-
vision
Value of
Project $
Permit $
Amount of
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 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 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 conditon 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 cr in the sta ments or specifications apd that he assumes responsibility for work
done by his agents, servants or employees. 1;
Signed BY
INSPECTOR -
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 or specifications subm9tsd to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant cr employee.
BY AUTHORITY
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.
Owner's Name and Address..
Registered Architect and /or Engineer
Name and address of licensed contractor.
4
.... -
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done ! 0 0 0 /N.& 4
State work to be done and purpose of building (by floors)
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Disapproved Date
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
1
ate...... .`-....." •
No
1 l s...
Street 1 0 O 0 16
and for no other purpose.
New Building Remodeling . .- Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
0 0
Estimated Total cost of improvements $- - - -j - �� 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 pennit 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 axe required by the Act. Village.
agrees to employ only such sub, tractors, on worky to be performed under this
Remarks (Signed). ///
permit, as are licensed b
y Miami Shores i age.
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._ 6 V V 'L- Date 1 'L ° VI 7 ead, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector i7 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- 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.
Owners Name and Address -_- 1 ,2..4, ./C AC i2. -
Regt tered Architect and /or Engineer
Chairman _
Member
Member
Council Approved
Building st' ector
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.
No., O_Q_././E Street._
Date
Name and address of licensed contractor_
Location and legal description of lot to be built on:
Lot__ Block Subdivision
Street and Number where work is to be done/. 6 1-- __ -6 '
State work to be done and purpose of building by floors)
and for no other purpose.
New Building Remodeling ___. ._ Addition Repairs No. of Stories /
To be constructed of Kind of foundation Roof Covering
O
Estimated Total cost of improvements $__ -__ Amount of Permit $ `�
Zone cubage required _ -Plan Cubage _.
Distance to next nearest building_ ___ . _ _______ Size of Building Lot
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 perrnit dot 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 hint
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 suc u bcontractors, work 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 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. 7
Permit No l.� U � � Date ____'o — 7- 4 7 ____ Read, Sworn to and Subscribed before me.
Disapproved ____ _ .._ Dat
Notary Public, State of Florida
(Signed)
My Commission Expires__
PLANNING BOARD __ . DATE
Member
Member
Member .
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 APPLICATION FOR MIAMI SHORES VILLAGE
Date 3 /O q9 Job Address /DO NE ` z Tax Folio
Legal Description Historically Designated: Yes No /C
1 Lessee / Tenant ) / M/ / 42/ G E
Owner's Address / 0 iV 9' Z;(te '' Phone 3 Zip ` T '
Contracting Co.,)( eahli - Address
Qualifier -
State # Municipal #
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle o BUILDING LECTR N
WORK DESCRIPTION— ,x7,i .go,6Z `ktu/6
64,k v- so/ ime.yl do/
hg co fa tii#i
Square Ft.
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF C
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTb
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE 0
Application is hereby made to obtain a pennit to do work and installation
will be performed to meet the standards of all laws regulating construction
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
RADON
Master Permit #
ID YO
OBTA
lthet'
derstf
C.C.F. 1 C v NOTARY 5 - ..N,.
SIGN
/4 lir
e
• INSULT INT YOUR
riff YOUR LENDER
I certify that all work
•ed for ELECTRICAL
OWNER'S AFFIDAVIT: I certify that all the foregoing information is ac laws regulating
construction and zoning. Furthermore, I authorize the above -named con, to
)ate
Date
APPROVED: TOTAL DUE ••■,
Zoning Building �P 9/i6)11 Electrical
Mechanical Plumbing Structural Engineer