MECHANICALBUILDING ❑ MIAMI SHORES VILLAGE FLORIDA
Date —� 19AP.
ELECTRICAL ❑
PLUMBING ❑ PERMIT NQ 8392 Contractor's
ROOFING ❑ License No. `•!› ` 3 rt
❑ Work to be performed under this Permit
Building D4 r Owner of
1 r / ^ ' t� rj
Architect
Contractor
or Builder la , I , ., a2 C'..- J ' ' 1
Legal Lot i
Description ii B1 T
Address of Z 7 / � j / �/&
Building
J. / d T e. � J /r .l r y . r� r.„,
7
n� �t r •
Ti c • ✓ t .a � `.�,t ,, Vd 7 , L..1 t B-
Subdi- l•° Ir A. –
vision
Sq. Ft.
Value of / et/ V =° I Amount of
Project 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 plan a changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above as mes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whethe own on the glens or dr wings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or e Ioy,es
Signed
(
_ _ -
In consideration of the issuance to me of this permit I agree t e orm the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, a te ents or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done either, m'self, my Eqpt, servant or employee.
CONTRACTOR or BUILDER
BY
CTOR) BY
AUTHORITY
3 r.►ev
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 buii
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami N
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.
tb b el?
Date
Owner's Name and Address 0 4 ' £__11 x' A V o 8 No
5 7 75 -
412ti G ,196?
Street__CA L Li /V S 4 M #4_
6eli.
Registered Architect and /or Engineer
Name and address of licensed contractor__a /_QtN1__2 4 _ =tQi t2 C m/et 1 2 9' _IS w, . 8 '] . c. ,4 "J �- lit 6-..
Location and legal description of lot to be built on:
Lot_______— Block Subdivision
Street and Number where work is to be done 2 7 9 AL G . 9 '7i' El 7
State work to be done and purpose of building (by floors) //) 3- 7 CI- C u N 42d U A E ' r J9_1i0€7
D u e r 402 /'c S _S is w ® f.) 1 . rel e∎I 3 r o ry
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 $ t %_1__ `f' Amount of Permit $
Zone cubage required_ ______plan Cubage
Distance to next nearest building
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 2_F/2_ /1 O o f Co Nk C t Y LA.), 711 L • 4 �°' �' i fl r /9
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 5988, 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 (Signe
Disapprove
( Signed)
Date
Date
_Size of Building Lot
STATE OF FLORIDA,
COUNTY OF DADE. j 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.
3 J 4
Permit No 9 -2 - Date �' L Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector '' My Commission Expires
PLAN I;OARD DATE
Chairman Member
Member Member
Member Member
Council Approved 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 si tice for inspection or faulty
materials and /or workmanship.