MECHANICALApplication 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__ A__ _ c11JN 0 5
Registered Architect and /or Engineer
Name and address of licensed contractor__ - 4v_L L
Location and legal description of lot to be built on:
Lot____ Block y Subdivision
lip Street and Number where work is to be dime 1.��___ t\ ___A____ Q
State work to be done and purpose of building (by floors)_ � `� �� ki s
- E N / Tit 'PL O 1- . 4,c -4 -
be sent to
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
EIUILDI NG INSPECTION DEPARTMENT
APPLII�ATION FOR BUILDING PERMIT
Date L 4
PP , 191g5
No. _1_� Street
for no other purpose.
•
New Building_____ Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements -- Amount of Permit $_____ ` ___:__4_____
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
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 Co:npensation 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 o r- site of t ork such • ublic no.pce
or notices as are required by the Act. The undersigned agrees to employ only such sub . t ', . work be i perms cJ under - this
permit, as are licensed by Miami Shores Village.
Remarks____________________ ( Signed)
Before me, the undersigned authority, a notary public, duly authorized to admi -': er oaths and take acknowledgments, personally ap-
peared
— ___ -- - - - - -- ---- - - - - -- 1 ___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 (a __ _ Date q 6 S
Disapproved Date
( Signed) _C.L ` `�u---�r
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.
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE _ ; 19
° PERMIT N9 6798 Contractor's
■ License No.
E
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
❑ Work to be performed under this Permit__
CONTRACTOR OR '3UILDER
B1
Subdi-
vision
Value of 1 f Amount of
Project $ II Permit $
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.
Signed. 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 submitted to the proper authorities of Miami Siiores Village. In aca
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY :YROT '''."4.7'41-
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 andior Engineer
„lame and address of licensed contractor
Location and legal description of lot to be built on:
Lot 1 6� :2 / /Block
Street and Number where work is to be donee% r
( work to be done and purpose of building (by floors). state exterior olors (submit samples)
4'
APPLICATION FOR BUILDING PERMIT
/! Subdivision s' `/ Le/// // JAW /5 g5
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
VoR r
L_Estimated Total cost of improvements S
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 :.aid 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 permit: and will post or c sett/ 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 s ch subco �
, / actors» work to be performed
under this permit, as are licensed by Miami Shores Village. / / ' _, „
Remarks (Sig _
n ed) j� . - 7 / l l � ��� � . t' =' - J
n/% ZYAc/� , /4/ ✓
STATE OF FLORIDA
COUNTY OF DADE. } ss.
Before me. the undersigned authority. a notary pt.blic. 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.
Date /CAZI68 9,
Permit No.
Disapproved Date
Signed)
Amount of Permit S
Read. Sworn to and Subscribed before me.
PLANNING BOARD DATE
Le /.
19
No.J v 7 Set . 9
Notary Public, State of Florida
and for no other purpose.
f 6 5 1 Aa a l0 // ®
My Commission Expires
Member
Member
Member
Date Disapproved Date
D e of 825.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
.lion fee of 825.00 will be charged when s•rch re- inspection is made necessary by improper notice for inspection or faulty materials and,or workmanship.