DECK1 1
\M SHORES VILLAGE
1 pUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade 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 bc kept at building during progress of the work.
Owner's Namc and Address 4 40i- . �� 5 _ No l ' . Street e S•
Registered Architect and /or Engineer :- ....P11 t•T,IMIS.,
Name and address of licensed contractor eac=r'+N
Location and legal description of lot to be built on:
Lot Q Block k el C Subdivision � _.._
Street and Number where work is to be done i CJ 1 • ._...
State work to be done and purpose of building (by floors) L. `' V i?ATI u wit c,i) ;.J 2 Trz P 1 IZ
!Z -J LT• t3 lrfi P?-4)v EATER-1 t: Wu() 0 Ed "? ikl1 O f} t2 -
- k$ .; -;- v A 2
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of VJO'D Kind of foundation C-C'Oc ? I� PIER.- Roof Covering N 01 � —
Estimated Total cost of improvements $ 7 Z 5 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 � " I3 :)i.t.lir S / CYLS /) € 4'7 S •f /n /A p i /=LCp rZ / 0 4-
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 bc 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 is employ only such ntractors, on woe to - e performed under this
permit as are licensed by Miami Shores Village.
Remarks '(Signed) t -
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 r, / + / O ( Ai t .
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the...c,i..%).),ra. — e.v. 772 C ro.t
of the above described construction, that he has carefully read the foregoing application, and that he did sign the sartte, and that all facts
therein by him sta ed are true.
Permit No.. __ - _ ! . a . - Date /"".c _ _ 71..___._ Read, S • . to and scri . ;. before nte.
Disapproved Date _.__ .. (2,0-71.....-' Notary lic, Stat of Florida
(Signed) ^ . NOTARY 7USLiC STATE Cr FLORID AT LARGE
But mg Inspe or My Commission Expires - Cry rg ,y - I i .A['R_1.?
tbONDED TiiRU GENERAL it ; • Iv v..l':jt,y.4 ,,r
PLANNING BOARD DATE
Chairman Member
Mcrnber 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 fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection of faulty
materials and /or workmanship.
J. H. MANUCY, INC.
LAND SURVEYOR
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1 • fj
4694 PALM AVENUE
HIALEAH, FLORIDA 33012
PHONE 821 -1281
821-1220
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FOR: FRANK T BOWES
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Survey of Lot 11, Block 180 of Revised Plat of Tracts 18OB,S2 of Tract 180C,
Tract 181A1' Tract 181B REVISED PLAT OF MIAMI SHORES SEC.Baccording to the Plat thereof
as recorded in Plat Book 43 at Page 51 of the Public Records of Dade County,
Florida ,
THE RORIDA
SOCmY
of
PEOPESSIONAL
LAND SURVEYORS
POUNDED
1953
'7 S . O
2.d 18
1 STY GB S
II 1o2
19 .)o
S.O
TM
1 HEREBY CERTIFY that the Plan shown hereon
represents a ncv made under my direction and
is True and Co •• .. to the best of my knowledge
and belief.
J. H.
Barney
10 co
6S
ucy Reg. Land Surrcr,or• No. 1 P 8
Herrick Reg. Land Surveyor No. 15193
State of Florida
? i .O4 35
v
7� ? Pi . I
ORDER NO. 1 F.B. 209 -49 REV.
5 ' vs./ `nv ALL
S S
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DATE: SEPT. 27, 1972