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FENCE4 1 , 0 5 c ) rS .✓ '� PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 10/499 Job Address /035 W E ` i L 5r Tax Folio �/ /f'I i A l i 5 /f-O2,E.s 3 GC .3 Legal Description t OT 1 W ! 2 5 ,el, ga. Historically Designated: Yes No Owner/Lessee / Tenant C IfiZ l5 Tt 4 „1 c CCJ Master Permit # �� 0 Owner's Address 1 35 IV -6 4.G0 57 Contracting Co. 5 IA Address 355 C.J oR r $ j /7 4 ,0 Qualifier P /a.uedo Lopez Phone 3 Faa 4 ,PO c ?O A/ State # Municipal # ( g 65 00A47Competenc # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Scpoe Ft. 111 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contr or to do the work st /99 ature of owner and/or Condo President ate FEES: PERMIT APPROVED: Zoning Building Mechanical Pe rce Or Pc-oe. o o 1 ' 1 1 1 WOOb EDe-E- urn f717 RADON C.C.F. NOTARY BOND Estimated Cost (value) P h o n e . 3 " . ) 0 . 5 - 7 , 5 4 ) -5 73 /1500 Signature of Contractor or Owner - Builder Notary as to My Commi ontractor or Owner - Builder ion Expires: Electrical ,,;,Fi %V :ii91." EVELYN L. PASCAL `' = MY COMMISSION # CC 889101 . :tl EXPIRES: January 2, 2002 ' $ ,' Bonded Thru Notary Public llndenwrilets 60 TOTAL DUE /°/5/9" Date / ° /%y Date Plumbing Engineering 10/01/99 FRI„ 12:14 FAX 305 536 7465 SSA3 N.W 7TH STREET, SURE 202 MIAMI. FLORIDA 33126 TELEPHONE: 0305) 270.3171 FAX. (305) ' +'+ -7022 DRAWN 0Y. SURVEY OF LPl_/ / :'' T e/ 4T /6— suBomsloN, RZILL -1 ffoRE sec pow iv.2 ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK NO 0 RECORDS OF COUNTY. �RI(aA� 7/Z` ATE' PROPERTY ADDRESS: .. 5-72.– . • -- ' Christian R. Bartholomew & Ana B. ?Brhhalomew Z/7: Scale 1 ' a FOR . AFC. ACT AIR COIIOI710NER PAO. ANCH0H EASEMENT. NYI - ALLU.N4U1.1 ROOF. • ALUra :NUtl SHED. L ^I•. .• ASPHAEI D C. • 010014. CORNER. eLOi: - DU:LCINC. Ex%• AEF:CII MAPK O.i . EASS2 OF DEARINOS C. C= LC.uL6TCD. 0.0. CATCH RAGIN. 0.5,7: • CONCRETE BLOCK STRUCTURE 0(4 - CONCRETE BLOCK WALT CI I - CHORD DISTANCE. CH. E 044030 BEARING. 01. • CLEAN C I. f . CHANT LINK PENCE. 0 M.2. • CANAL MAINTENANCE 8 (41.1ENT. CONE CONCRETE. ▪ 1:0:40. PORCH I.1/ . COr.CFP1E SUS. '•. r • Or+4e:AGF EASEMENT . O1AI'14 P 0AINTENANCE • C FA; CME4T. Dgiv •C.RIVE AY 7 r . !LEE I RIC TPAN(FOHr.1ER • CLE 414CM - 001 R7A0444EN1 H • :IRE MYI1R.ANT. IRON PIPE (4.4 R . PT IRON ROD. P P 4 - 7141 P100P ELEVATION. Pion Ouruelort J� LAND SURVEYORS AODHEWA /ION AMD .E.thEt0 L.N.O. - POUND NAIL A DISK. P.R.C. - POINT OF REVERSE FR, - FRAA15 CURVE. FT. A FEET. PROP. CDR. - PROPERTY CORNER. P.8.. PLAT ROOK PG. = PAGE. Ayr' PARKWAY. PRM - PERMANENT REFERENCE MONUMENT. P.L.S. PROFESSIONAL LANG SURVEYOR. R. a RECORDED DISTANCE. RH. a RAILROAD. RES. RE 10(4405 P/LV, c RK{HT•OF -WAY. RAD. a RAONS OR RADIAL R.P. a RADIUS POINT. RGE. a RANGE SEC. - SECTION. STY. - STORY. 5wK. a 5(OEWALK 51.P. - SET IRON PIPE L.B. •004: S. - SOUTH. S.N.O. = SET NAIL 5 D15K LB.'00 SP. - SCREENED PORCH. - SECONDS. 7 - TANGENT TWP. - TOWNSHIP. U.C. 4(714110 EASEMENT. UTIL • 11T1UT'. U.P. - UTILITY POS. W.M. .. WATE3 45TER w.f. a WOOD FENCE. e CENTRAL ANGLE. LY - WEST. • CENTER LINE 4 A ANGLE. PNIP. • FCDeRAL NATIONAL IN4044806 PROGRAM. P .N • FOUND NAIL. N - NIGH (11EIGH1). IN. A CG... INGRESS AND ECReSS EASEMENT. L.P. a LIGHT FOLE. L F 6 - LOWEST FL00P ELEVATION. LATE. • LAKE MAINTENANCE EASEMENT. • e MINUTES. M. a MEASURED DISTANCE. MON. • MONUMENT. 2(11. • 41ANNOLE. MONUMENT UNE. N A.P._ NOT A PART OF. N'G50 = NATIONAL GEODETIC VERTICAL 00.TU.. N - YTORTH N.T.S. a NOT TO SCALE - NO.+ NU0SF3. G'S. UFF3FT OH. a OV'OHMIUD. Ov44.. OVERHANG. 0 R.6 •OFFICIAL RECORD ROOK. NJMT. - PAVEFrEN1 PL - PLANTER F:L = PROPER7Y UNE. P C.0 - POINT OP 001aPOUNO. CURVE. P.0 - POINT OF CURVE. PT. _ Po/4T OF TANGENCY FOE. a PONT of COMMENCEMENT POS. a POINT OP 620 44INO. LOCATION SKETCH LEGAL NOTES TO ACCOMPANY SKETCH OP SURVEY IUURVEY): CAALCN4710N OP THE ABSTRACT OP TITLE WILL HAVE TO EC MADE TO 064444/4 44 RECORDED INS 1H.:'.1C11TC,.IF ANY. AFFECT NU IHh PI4VI'CHI T. I HQ) Ruhr ET l av0*CVI .v •w -V. P.IITATInN:< RESTRICTIONS. RESERVATIONS OR CASEMENTS OF RECORD 6GAL DESCRIPTIONS PROV:083 AT CLIENT OR ATTESTING TITLE COMPANY 5KETGH DE SV"VPY MEANS A DRAWING AND'OR A GRAPHIC R?PPESF OP 7■5 SURVEY WORK Pe RFr1.R7.ICR 1:4 'NE FIELD. COULD BE DRAWN AT* SHOWN SCALE 4N0/OR NOT TO SCALE. N-F. LIAD.LITY OF THE SURVEY IS LIMITED TO THE, COST OP THE SURVEY. H6 TEHM';NCROACKMENT MEANS VI518LE two ABOVE GROUND ENCROACHMENTS. ARC IS SHALL VERIFY ZONING REGULATIONS. RESTRICTIONS AND SETBACKS AN0 T HEY WILL D_ RE5P0r:z10LE OF SURMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR 114£1R A ^PTINAL. 00:1 AUTHORIZATION TO AUTHORITIES IN A NEW CONSTRUCTION. UNLESS OTHERWISE N0: EU, THIS PIaM HAS NOT ATTEMPTED TO LOCATE FOOT(NG5 *00/03 FOUNDATIONS. FENCE OWP•'SRSINP NOT DETERMINED. T1 /0 r ;1" F1 CCD MOPS HAVE OCSIGN4TE0 THE HEREPJ DESCRIBED LAND TO 0E SITUATED :N BONE _ x � CO /-IMUNI . 1 2 .. PANEL, 0093 - SUFFIX � JJ / OASE FL000 ELEVATION —, N /A DATE Cd DRL) .---- . -- ...— cEF1;.IF0 TO Christian R. Bartholomew & Ana B. Rarthalomew At'tlu— neys''- Title- iltsur'ance FUr InC. . . . Legal- Title-Services -.. ...__. _. _. --.... • _. . Standard..Federal Bank, its successors dior- assigns US SEC & EXCH COMM -SERO ant AT PAGE NO OF THE PUBUC 7 33/ C A^ IY -37 1 7m 0.00 X W.0 SIVRY.EXORS 2 NOTE 1), IF SNOwN, BEARINGS ARE REFERRED TO AN ASSUMED MERIDIAN. GT SAID PLAT w THE OESCRIPTON OF THE PROPERTY. ■ NOT, THEN BEARINGS ARE REFERRED TO COUNTY TOWNSHIP MAPS. 7) IF SHOWN. ELEvAT10NS ARE REFERRED TO 8.4./ ELEV OF N.G.V.O. OF 19'49. 3). THIS 'SKETCH OF SURVEY' REPRESENTS A LAND 546467, ALSO REFERRED AS A BOUNDARY SURVEY. 3A.) THIS IS A SPECIFIC PuRPOSe SURVEY, Jy1E CLOSVR6 THE SOUNOARY SURVCY 15 ENE 1:7500 FT. 4 44 7 (4 (4 1 (4 7 1 7 ) 4 4 7 30 ( 5 THIS 'SKETCH OF SURVEY' OF THE PROPERTY OE5CR1860 HEREON, AS RECENTLY SURVEYED AND DRAWN UNDER MY SUPERVISION. COMPLIES WITH THE MINIMUM TCCHNTCAL STANDARDS AS SET FORTH BY THE FLORIDAOOARO OF PROFESSIONAL LAND SURVEYORS IN CHAPTCR 610174 FLORIDA ADMINISTRATNE CODE PU38L14 4T TO *711.027, PLORID4 STATUTES. r4 IBARRA MATE OF FIELD Z�97 PItO $gK)HAL LAND SURVEYOR NO. 5Z04- STATE OF FLORIDA. (VALID COPIES OP 1(15 SU'V0Y WILL SURVEYOR). REVISE0 REVISED ON ND /Of SURVEY NO LFGFND TYP5C . WOOD FENCE. CHAIN LINK FENCE. C.B.S. WALL (C.B.W.) EXISTING ELEVATIONS. 2002 PAOPOSED ELEVATIONS. n t•T a1 \ // 4� J 91 , 11.t. I z±1 4C , dl 10/01/99 FRI„ 12:14 FAX 305 536 7465 SSA3 N.W 7TH STREET, SURE 202 MIAMI. FLORIDA 33126 TELEPHONE: 0305) 270.3171 FAX. (305) ' +'+ -7022 DRAWN 0Y. SURVEY OF LPl_/ / :'' T e/ 4T /6— suBomsloN, RZILL -1 ffoRE sec pow iv.2 ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK NO 0 RECORDS OF COUNTY. �RI(aA� 7/Z` ATE' PROPERTY ADDRESS: .. 5-72.– . • -- ' Christian R. Bartholomew & Ana B. ?Brhhalomew Z/7: Scale 1 ' a FOR . AFC. ACT AIR COIIOI710NER PAO. ANCH0H EASEMENT. NYI - ALLU.N4U1.1 ROOF. • ALUra :NUtl SHED. L ^I•. .• ASPHAEI D C. • 010014. CORNER. eLOi: - DU:LCINC. Ex%• AEF:CII MAPK O.i . EASS2 OF DEARINOS C. C= LC.uL6TCD. 0.0. CATCH RAGIN. 0.5,7: • CONCRETE BLOCK STRUCTURE 0(4 - CONCRETE BLOCK WALT CI I - CHORD DISTANCE. CH. E 044030 BEARING. 01. • CLEAN C I. f . CHANT LINK PENCE. 0 M.2. • CANAL MAINTENANCE 8 (41.1ENT. CONE CONCRETE. ▪ 1:0:40. PORCH I.1/ . COr.CFP1E SUS. '•. r • Or+4e:AGF EASEMENT . O1AI'14 P 0AINTENANCE • C FA; CME4T. Dgiv •C.RIVE AY 7 r . !LEE I RIC TPAN(FOHr.1ER • CLE 414CM - 001 R7A0444EN1 H • :IRE MYI1R.ANT. IRON PIPE (4.4 R . PT IRON ROD. P P 4 - 7141 P100P ELEVATION. Pion Ouruelort J� LAND SURVEYORS AODHEWA /ION AMD .E.thEt0 L.N.O. - POUND NAIL A DISK. P.R.C. - POINT OF REVERSE FR, - FRAA15 CURVE. FT. A FEET. PROP. CDR. - PROPERTY CORNER. P.8.. PLAT ROOK PG. = PAGE. Ayr' PARKWAY. PRM - PERMANENT REFERENCE MONUMENT. P.L.S. PROFESSIONAL LANG SURVEYOR. R. a RECORDED DISTANCE. RH. a RAILROAD. RES. RE 10(4405 P/LV, c RK{HT•OF -WAY. RAD. a RAONS OR RADIAL R.P. a RADIUS POINT. RGE. a RANGE SEC. - SECTION. STY. - STORY. 5wK. a 5(OEWALK 51.P. - SET IRON PIPE L.B. •004: S. - SOUTH. S.N.O. = SET NAIL 5 D15K LB.'00 SP. - SCREENED PORCH. - SECONDS. 7 - TANGENT TWP. - TOWNSHIP. U.C. 4(714110 EASEMENT. UTIL • 11T1UT'. U.P. - UTILITY POS. W.M. .. WATE3 45TER w.f. a WOOD FENCE. e CENTRAL ANGLE. LY - WEST. • CENTER LINE 4 A ANGLE. PNIP. • FCDeRAL NATIONAL IN4044806 PROGRAM. P .N • FOUND NAIL. N - NIGH (11EIGH1). IN. A CG... INGRESS AND ECReSS EASEMENT. L.P. a LIGHT FOLE. L F 6 - LOWEST FL00P ELEVATION. LATE. • LAKE MAINTENANCE EASEMENT. • e MINUTES. M. a MEASURED DISTANCE. MON. • MONUMENT. 2(11. • 41ANNOLE. MONUMENT UNE. N A.P._ NOT A PART OF. N'G50 = NATIONAL GEODETIC VERTICAL 00.TU.. N - YTORTH N.T.S. a NOT TO SCALE - NO.+ NU0SF3. G'S. UFF3FT OH. a OV'OHMIUD. Ov44.. OVERHANG. 0 R.6 •OFFICIAL RECORD ROOK. NJMT. - PAVEFrEN1 PL - PLANTER F:L = PROPER7Y UNE. P C.0 - POINT OP 001aPOUNO. CURVE. P.0 - POINT OF CURVE. PT. _ Po/4T OF TANGENCY FOE. a PONT of COMMENCEMENT POS. a POINT OP 620 44INO. LOCATION SKETCH LEGAL NOTES TO ACCOMPANY SKETCH OP SURVEY IUURVEY): CAALCN4710N OP THE ABSTRACT OP TITLE WILL HAVE TO EC MADE TO 064444/4 44 RECORDED INS 1H.:'.1C11TC,.IF ANY. AFFECT NU IHh PI4VI'CHI T. I HQ) Ruhr ET l av0*CVI .v •w -V. P.IITATInN:< RESTRICTIONS. RESERVATIONS OR CASEMENTS OF RECORD 6GAL DESCRIPTIONS PROV:083 AT CLIENT OR ATTESTING TITLE COMPANY 5KETGH DE SV"VPY MEANS A DRAWING AND'OR A GRAPHIC R?PPESF OP 7■5 SURVEY WORK Pe RFr1.R7.ICR 1:4 'NE FIELD. COULD BE DRAWN AT* SHOWN SCALE 4N0/OR NOT TO SCALE. N-F. LIAD.LITY OF THE SURVEY IS LIMITED TO THE, COST OP THE SURVEY. H6 TEHM';NCROACKMENT MEANS VI518LE two ABOVE GROUND ENCROACHMENTS. ARC IS SHALL VERIFY ZONING REGULATIONS. RESTRICTIONS AND SETBACKS AN0 T HEY WILL D_ RE5P0r:z10LE OF SURMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR 114£1R A ^PTINAL. 00:1 AUTHORIZATION TO AUTHORITIES IN A NEW CONSTRUCTION. UNLESS OTHERWISE N0: EU, THIS PIaM HAS NOT ATTEMPTED TO LOCATE FOOT(NG5 *00/03 FOUNDATIONS. FENCE OWP•'SRSINP NOT DETERMINED. T1 /0 r ;1" F1 CCD MOPS HAVE OCSIGN4TE0 THE HEREPJ DESCRIBED LAND TO 0E SITUATED :N BONE _ x � CO /-IMUNI . 1 2 .. PANEL, 0093 - SUFFIX � JJ / OASE FL000 ELEVATION —, N /A DATE Cd DRL) .---- . -- ...— cEF1;.IF0 TO Christian R. Bartholomew & Ana B. Rarthalomew At'tlu— neys''- Title- iltsur'ance FUr InC. . . . Legal- Title-Services -.. ...__. _. _. --.... • _. . Standard..Federal Bank, its successors dior- assigns US SEC & EXCH COMM -SERO ant AT PAGE NO OF THE PUBUC 7 33/ C A^ IY -37 1 7m 0.00 X W.0 SIVRY.EXORS 2 NOTE 1), IF SNOwN, BEARINGS ARE REFERRED TO AN ASSUMED MERIDIAN. GT SAID PLAT w THE OESCRIPTON OF THE PROPERTY. ■ NOT, THEN BEARINGS ARE REFERRED TO COUNTY TOWNSHIP MAPS. 7) IF SHOWN. ELEvAT10NS ARE REFERRED TO 8.4./ ELEV OF N.G.V.O. OF 19'49. 3). THIS 'SKETCH OF SURVEY' REPRESENTS A LAND 546467, ALSO REFERRED AS A BOUNDARY SURVEY. 3A.) THIS IS A SPECIFIC PuRPOSe SURVEY, Jy1E CLOSVR6 THE SOUNOARY SURVCY 15 ENE 1:7500 FT. 4 44 7 (4 (4 1 (4 7 1 7 ) 4 4 7 30 ( 5 THIS 'SKETCH OF SURVEY' OF THE PROPERTY OE5CR1860 HEREON, AS RECENTLY SURVEYED AND DRAWN UNDER MY SUPERVISION. COMPLIES WITH THE MINIMUM TCCHNTCAL STANDARDS AS SET FORTH BY THE FLORIDAOOARO OF PROFESSIONAL LAND SURVEYORS IN CHAPTCR 610174 FLORIDA ADMINISTRATNE CODE PU38L14 4T TO *711.027, PLORID4 STATUTES. r4 IBARRA MATE OF FIELD Z�97 PItO $gK)HAL LAND SURVEYOR NO. 5Z04- STATE OF FLORIDA. (VALID COPIES OP 1(15 SU'V0Y WILL SURVEYOR). REVISE0 REVISED ON ND /Of SURVEY NO LFGFND TYP5C . WOOD FENCE. CHAIN LINK FENCE. C.B.S. WALL (C.B.W.) EXISTING ELEVATIONS. 2002 PAOPOSED ELEVATIONS. 10/01/99 FRI 12:15 FAX 305 536 7465 NI • $912 7TH STMT. WTI 202 MMM . FLORIDA 23121 TELEPHONE 000) f3 .3 FAL ME 550922 US SEC & EXCH COMM -SERO Nova Purnrqurs Att. LAND SURVEYORS 9G ' -,anti P / SKETCH OF SURVEY State 1" _ VONMY 99.-ggr S+rtEY NO `' OP ®003 WOOD FENCE DESIGN DETAIL • . N.T.S. 7., AR MAILS AND O NNECTORS lot SHAII BE GAI.YAHQED 0 1 4 Supplement No. 3 2X4 Ms. 3 P.T. W000 RAILS p( L WITI. ATTAU{ED TO WOOD POST WITH WIS. (11101KM.S VI Ka 2 P.T.WOOD POST • -4— i t D4A, COItCRE 1 E FOOT I (25co r 0 �') FENCE HEIGHT POST A30YE GRADE SPAiHS 6'47'( x ) 4' arc S-0' do 4.4r 6'-0• ore 1,c C. of 1s8 .40— 41.0[1 W000 FicriiS. sir MIX. DRESSED 1H1CK}I ATIACH EACH PICI<E1 10 RAII WITH (2)1X6A STARES 1.3/1' LONG. N soakin skinuimprta CALL (1V 1SM 1944) 2973.2 Location and legs description of lot to be built on: ' W �Ob Lot / �S Block e- Street and Number where work is to be done New Building MIAMI SHORES VILLAGE 7s-44_ /(4.J 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. D a et Owner's Name and Address p �'e/1 �-�' ` � ( ' 1r^ ecI 5 No �� �. Street / b Registered Architect and /or Engineer Name and address of licensed contractor ..-State work to be done and purpose of building (by oors), state exterior, colors (submit samples) �F c ep w w0 �� e v c. 1 5 Subdivision Pi/ , P�� // So / 3ZY/ J l oL (, d and for no other purpose. Remodeling Addition Repairs No. of Stories at.1,1"'%. II .1 LC.-- 'lb be constructed of Kind of foundation Roof Covering L.-Estimated Total cost of improvements $ 15 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 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 Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has com • ed w compliance from all contractors or sub - contractors employed by him in the work to be performed under this on the site of the work such public notice or notices as are required by the Act. The undersigned agrees under this permit, as are licensed by Miami Shores Village. Remarks (Signed) on& here or cause uc subcontra STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgrnents. personally appeared er of Labor und-t e Florida Workmen's • and will require similar • be posted for inspection rs, on work to be performed 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. 8 8® Disapproved (Signed) 9 Date_G L e Read, Sworn to and Subscribed before me. Date 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 $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials andfor workmanship. % T cz,7. \\ ,.) R -.. ■N ‘ 'i C IO • Ag• g /70 , ..36 /• (Year V huoi AI/ Azle SKETCH OF SURVEY SCALE: I". 7.31 THIS IS A BOUNDARY SURVEY Ce ( N) oo,/e tr" 17;7* - 7 , flg - 4 0 Ade /-3 is /" SrAo/1 ver'neril 0 0' z1/0 • \ 1-STY- C.13.5 • , es i/F? L a ,ed es/ //oar cr/ev // 33 4 ) `.% .4' 0 7 / PO ricu./ 01 5.3 '/ / x- 1 49%.C. Lo 05e_ 100 r r Lib 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. Owner's Name and Address No Street Registered Architect and /or Engineer 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 7 b – State work to be done and purpose of building (by floors) r " and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation 1 Roof Covering , 7 A ;i' , i 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 - 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 5968, Compiled General Laws of Florida, Permanent Supplement, and has complied with the rovisions 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 the Act. The undersigned agrees to employ only such s ontractors, on work to be perfo ed under this Remarks permit, as are licensed by Miami Shores Village. Date , 19 w �� STATE OF FLORIDA, ; p4 : " n✓'y �!� 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 :crown, 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 Read, Sworn to and Subscribed before me. Disapproved Date 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 $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.