24406Remarks...
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Disapproved —
(Signed)
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or toe plans and specifications herewith submitted for the build.
in 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 sped" copy of approved
plans and specifications must be kept at building during piogress of the work.
Date
Owner's Name and Address ..1/22.4.e. 2Z4gAti&—
;
Registered Architect and/or Engticeer.. L ' 4 . - )4 4 / .4... %Th?..e.$14.a. — -.....m
Name and address of licensed contractor ...... tr.1...0.kar..... 7 o...s...s.e...../ci e • ....._..... ..
Location and legal description of lot to be built on:
Lot Block - — Subdivision — -----
Street and Number where work is to be done C32 96 '57 /View, 4. 1a5) ... 4 State work work to be done and purpose of building (by floors). z - EX i5 7/A/4 .1..ML‘ti...&LrA/4
-YR . —a:eXd" 7e" r 7c// ‘ne <C.< C,5/ 02C/1
— . ........and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories ...... ..----.....—
•
To be constructed of Kind of foundation- — Roof Covering. *NY
Estimated Total cost of improvements $ ./- • ..° .Amount of Permit $.... .. - — .. — .... —
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 employee
of labor under the Florida Workmen s Compensation Act, being Section 5966, Compiled Genera ws of Florida, Penn. . nt Supplement,
and has complied with the provisions thereof, and will require similar compliance from all co ors or sub-contra! , mployed. by him
in the work to be performed under this permit; and will post or cause to be pcisted for insp on the site of the such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su to domed under this
pennit, as are licensed by Miami Shores Village. .
P V-4ndlli
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 Read, Sworn to and Subscribed before me.
A
• Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date.
(Signed)
Notary Public, State of Florida
•••••••••••■••••• •••••■•• • ••
11•1••••••••
My Commission Expires
PLANNING BOARD. .... —DATE
Chainn — ........ Member 00••••••••••• ....... ••••••••••••••* ••••••••••••••••••••••••••••••••••••••••••••••.
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 anti/or workmanship.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Disapproved _.._..._._..._. .. .... Date
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approvvai of the detailed statement of we plans and specificationkherewith 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 iiuiiding 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 p:?ogress of the work.
Date ,18..
Owner's Name and Address ....0 ap ,.S,JQ ,2Xe t eXiaf .ghureh » No.-
St •
Registered Architect and /or Engineer „,,......., „ „ ..».:.. nr. „... , ... , ,n„nre,are- n,nn.exx,,,
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot .. ........... Block. Subdivision
Street and Number where work is to be done».„..._.....§ NE ., St
State work to be done and purpose of building (by floors) Re- roof highest tw9 Btory t,`.l.at roofs only_
_ .._ _._.. „_.._.._...„ _.. »... »......... ...37._.x... i ....»..._.
.._ „.._...... »....„.. ..._»..._ ..*OM ._.. „....„ .......and for no other purpose.
New Building Remodeling Addition Repairs .X ....... »...._.. No. of Stories...... Pr......» ».....»
To be constructed of Kind of foundation »»..._......._. .. Roof Covering..._ ..... .g,1;o,`lea.. ........ ..._.._._
Estimated Total cost of improvements $ 5a 3 a.QQ _» .._ „.„.._.Amount of Permit $.. ........20.QQ ................... .... .... ... ...
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. AU 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 ‘Vorktnen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Pennanent 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. .
r
Remarks ._...........„ ..... (Signed) :,,' .v
7
Member ......„.
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. Date.... ._...._ Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
PLANNING BOARD .. .......... _ .._.._..._DATE
Notary Public, State of Florida
Chairman
.\fcrr bee . .................... „......_..„ ... ......_.... „.„ ..... . Member „... ._.. .._........... .._.. ._....»...._..._..... „.. _ .._
Mcrnber ........._.. _ „........_........_.— _._...._ 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.