14090MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIl
Application ik 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
,19
Registered Architect and/or Engineer • gr
Name and address of licensed contractora
Location and legal description of lot to be built on:
Lot Blodc O Subdivision
Street and Number where work is to be done
----
State work to done and purpose of building (by floors eteCieSk____
New Building V Remodeling Is
To be constructed °LC_ S Kind of foundation
Estimated Total cost of improvements $ boo Amount of Permit $
Zone eubage 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 accents his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida, Permanent Suppkinent,
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 nested 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 srk to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Sign - 40,
ClASZ ./
a
STATE OF FLORIDA,
COUNTY OF DADE. f 8S.
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. - -
Permit No /q ct Date U Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
r+ • -
■11.16.- AIN
le WV'
PLANNING BOARD
Chairman
Member
Member
Council Approved
and for no other purpose.
Addition ik Repairs____________ No. of St(ap t
Roof Covering 47:1-24kt,G
Notary Public, State of Florida
My Commission Expires
_DATE
Member
Member
Member • -
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 worlansmship.
OWNER'S
Miami Sh res Pres. :-
NAME 'I
Church •
'13ESENT ADDRESS,
LICENSE NO.
PHONE NO.
J OB
N.E. 96t3
LOCATION - L I ST. OR AV .)
Street and 6th Ave.
LO'
10
BLOCK
'61
SUBDIVISION
MS •
GENERAL CONTRACTOR
I 1
Paul C. Iarrieon
ADDRESS
PHONE NO.
LICENSE NO.
�yn�nU
BUILDING PERMIT' NO. ] '�' -`
DATE
_� rl
PERMIT FEE $ 4°
BUILDER'S BOND•
NO. DATE
ZONE REQUIREMENTS CU.
T.
747
PLAN CUBE 10! CU. FT.
EST. i COST $
DRAWINGS. S'ECIFICATIONS,
RESTRICTIONS AND CUBE CHECKED Bl�i .
I DATE
NEW CONSTRUCTION
.TYPE
ISTORI as
I ROOF CONSTRUCTION
1J 4
INTERIOR CONSTRUCTION
REPAIRS
room addn,
and r
DESCRIPTION
to kitchen
ALTERATION
DESCRIPTION
1.
ADDITION .
SUBMITTED TD PLANNING BO RD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING
, 3OARD
, ;�
SUBMITTED T VILLAGE COUNCIL
REMARKS
I
CERTIFICATE
OF OCCUPANCY
NO.
ISSUED ( IB
TO
BU
LDING PERMIT AND INSPECTIO1
RECORD —MIAMI SHORES VILLAGE p.
it
BUILDING INSPECTIONS ( / J a
INSPECTIONS =_
DATE
BY
_ RE- INS
BY
RE- I- NSPECT
BY- -
FOUNDATION
% 1 '¢
� •
BEAMS & LINTELS
FRAMING
FINAL
M
i 2 -s1
�\
4�t.
CLEAN -UP
It
A I
PLUMBING PERMITS & INSPECTIONS
CONTRACTOR
PHONE
PERMIT NO. 1 DATE
FEE $
NEW BLDG. I ALTERATION I, ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
_
SEPTIC TANK
$
SEWER
$
SOLAR HEATER
$
GAS
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
GAS
SEWER
SEPTIC TANK
SOLAR HEATER
FIXTURES
, ELECTRICAL. PERMITS & INSPECTIONS
CONTRACTOR
PHONE
PERMIT NO. 1 DATE
FEE $
NEW BLDG.
1 ALTERATION 1 ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
APPROVAL TO POWER CO. FOR SERVICE DATE
BY