1180 NE 97 StSTATE OF FLORIDA,
COUNTY OF DADE. ss.
WBAM S
UILDING INSPECT :ON 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.
Date__l ,i _ � , 19 - »
Owner's Name and Address._ Street -
Registered Architect and /or Engineer _ ° ----- .
Name and address of licensed contractor v -
Location and legal description of lot to be bui)t on:,
Lot Block f Subdivision
Street and Number where work is to be done � � e
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
Estimated Total cost of improvements $ Amount of Permit $� / �� '
Zone cubage required 2' s` _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. Ali notices with reference to the building and its construction may
be sent to
LADE
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 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 subcontractors, on work to be performed 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, b g by me first duly sworn, upon c th deposes and say hat he is the
of the above .escribed construction, that he has carefully read the oregoing application, and that he did sign the same, and that all facts
therein by hi stated are true. J 2 y
Permit No
'Date / /, c Read, Sworn to and Subscribed before me.
Disapproved \ //_ Date
(Signed) 4, ��/ = /
\ , Building Inspector`
r
4
Notary Public, State of Florida
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.
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Order # 2677
F. E; # 979-4C
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Scale: r-450'
SKETCH OF !SURVEY
LL:t. Block igl, SECTION NO E OF MLA SHOREE, according to the plat thereof
recorded In Plat Book 14, at Page 33, of the Publle Records cf Dade County,
Floriea, and the East 25 feet of Lot 2, Block lel, REVISED PLAT OF TRACT
of TRACT 18CC, TRACT lglA AND TRACT 1g1P, OF TH REVISED PLAT OF MIAMI
3HCRES, :2,ECTION ?, according to tne plat thereof recorded in Flat Rook 43, at
PaFe 51, of t:Ie Public Records of Dade C unty, Florida.
For
1'
5 /
Clyde DePrima
FIXAYNF Y%7TINEERING COMPANY
Civil Engineers
Miami Florida
By
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2
75
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ST s e%
June 2nd, 1952.
Scales Shown
WE liEREEY CERTTFn That the attacn.ed "SKETCH OF SURVEF_" of the above
described prol is true and correct to the best of our knoyledFe and belief
as recently surveyed arld platted under nur directicn; also that there are no
encroachment u.nless shown therecr,
BISCAYNE ENGINWYRING COMPA7;Y
." O
J. enne
e stered Engineer # 145
e tered Survey7:r # 46
TAT ';i: OF FLORIDA,
75
75'
Sea/c: /"-20'
Pipe
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