685 NE 97 St (17)Registered Architect and /or Engineer _ _
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot. Block ....._
Street and Number where work is to be done
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Permit No......
Disapproved .. _.... .._...
(Signed) ._ -- • _ -- .. - • - _
Chairman
Member
Member
Council Approved
MIAMI S (H s RES VILLAGE
BUILDIN` INSPECTION DEPARTMEN'
AF L9C. kTO ®N FO
LIILD NlG 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 herer_' described This :application is made in compliance and conformity with the Building Ordinance of
Shores Village, Florida, and all provisions of the Laws cf the State. of Flurid.) all o finances of Mi, mi Shores Village and all iules and
regulations of the Building l)ivi:,i •ai of liiam Shots 1 illage h )!1 ',e , oi iplied with, whether herein specified or not. A copy of approved
plans and specifications must be kep• at building durin6 progress of tl.e work.
3
Owner's Name and Address ...__.C. _ u are 4 - d No.
/ 'G am. . -- .... 0 al t °7°4
Subdivision
Date
Notary Public State of Florida
Street
State work to be done and purpose of building (by floors) ...... A' dr i
2. . Date.. B ° � Read, Sworn to and Subscribed before me.
,19
and for no other purpose.
New Building.... ........ _ . Remodeling_ .___ ... ..... Addition._ . __ ... Repairs . No of Stories
• To be constructed of ... . ... _ Kind of foundation . Roof Covs'rinng
® `rT
Estimated 'I' stal cost of improvements $_ _ .. Amount cc Permit $ . _ .
Zone cubage required ._. _plan Cubage_•-- - -- - -- -- - - ------ -- --
Distance to next nearest building__ _ _ Size of Building Lot
Maximum live load to be borne by each floor
hereby submit all the plans and speciiii•ations for said building. All notices with reference to the building and its construction may
be sent to ...._._ _ _ . __ _
The trade signed appli ant for this budding permit does hereby certify dolt he understands and accepts his obligations as an employer
of 1:.bor under he Florida Workmen's Compensation Act. being S. •tion 5968, Coe-pled Gen al Laws of Florida P r • anon. Sn ..cent,
and h s compl ed sv tli he limy' aons thereof, and will require simiiar comm tame from all contractors or sub - contractor:, eniplo -cd by hint
in the wo k to be p rf med under ties pern.it and 'gill post or cause to be posted for inspection on the site of the work su •h public not), e
or notices as are regwr d Ly the Act. The u, d, r •igru. d agrees to employ only such subcontr. ctors, on work to be perform d . der this
permit as are licensed by M am: Shores N il:: go.
Remarks_ (Stg•ied )
Before me, the undersigned authority, a notary public, duly authorized to administer oaths ..nd take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first d ly sworn, upon oath depo ?.es and says that he is the
of th abov. de c ibed istruction t;. t is has careially read the foregoing application, and that he did sign the same, and it at _Al tarts
therein by him stated are tr ie.
Date_ .
Building Inspector My Com:nisgion Expires. .__. .......
PLANNING BOARD _ . __.. _ DATE
Member
Member
Member
Date Disapnrok eel Date
NOTE: A charge of $1.00 will be ninde for making corrections or changes to this application .'ftrr approv 11 11.s le( r-btamned from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is mi is ncces;ar) by improper notice fcr imp,• hi)) or fa! ty
materials and /or workmanship.
BUILDING ❑
MIAMI SHORES VILLAGE. FLORIDA
ELECTRICAL El �1, *T r� DATE 195
❑ PERMIT jv ° 8170 1 0 Contractor's
PLUMBING
License No
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
B i.
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of
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 application
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 responsibility for work
done by his agents, servants or employees.
Signed: BY
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 Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
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.
l n Date - -e—e -- � - 2 — /�/ , 19 .�
Owner's Name and Address._ 4 / H�- ' 1 t r X No ® �3:/ Street ,` i sr
Registered Architect and /or Engineer
Name and address of licensed contractor /i /l t
Location and legal description of lot to be built on:
APPLICATION FJJR BUILDING PERMIT
Lot Block // Subdivision
Street and Number where work is to be done.. �9 ' d t1 - �•
Building i nspector
MIAMI SHORES VrLLAGE
BUILDING INSPECTION DEPJkR1'MENT
State work to be done and purpose of building (by floors)
Yp ,, t Se IF V 1 e-
s
New Building Remodeling. Addition Repairs
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 14- S o o Amount of Permit $ • 0 O
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 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, o wor to be perfor d u er this
permit, as are licensed by Miami Shores Village.
Remarks (Signed).
Read, Sworn to and Subscribed before me.
g-� g't" `,(S ,(e
2 jEjt
and for no other purpose.
No. of Stories E
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
to me well known,
who, being by me first duly sworn, upon oath deposes and says that he is the.
or 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 ACS 7 Date / — 2-
Disapproved Da e
(Signed)
Notary Public, State of Florida
y 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 front
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.
e
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