27337Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 Shares 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.
\4411 Name and Address �- �/,
Rest ))?`
Architect and/or Engineer /7 L .) A 0 E
Name and address of licensed contractor
Location and legal description of lot to be built
eft � ��
Lot � �locic Subdivision �� :♦ A '�_
Street and Number where work is to be done C ?- 4• r 6 2
State work to be done of building (by floors). state exterior colors (submit samples)
-4 CjsL.Fr0 i . o's 7Ilf 4 re (--7 v ei p' 2-
and for no other purpose.
New Building Remodeling Addition
1b be constructed of f Kind s ' y , oundation
Estimated lbtal cost of improvements $
Zone cubage required Plan Cubage
Distance to next nearest building
Maximum live load to be borne by each floor
I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to
MIAMI SHORES VILLAGE 7J / -- /at
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
® o
Remarks IS
PLANNING BOARD
Member
Member
Council Approved
Repairs No. of Stories
/2 /s- e Roof Covering 4/ P
VI OP
Amount of Permit $
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o
Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and
compliance from all contractors or sub - contractors employed by him in the work to be performed
on the site of the work such public notice or notices as are required by the Act. The undersigned
, under this permit, as are licensed by Miami Shores Village.
f020
‘'G-& a29
, 19 p,
Date
Na V 0 4S---- Street i 'F..
ize of Building Lot
as an employer of Labor under the Florida Workmen's
with the provisions thereof, and will i similar
- be y , isted� j <spection
only such saa, :, ormed
0(
STATE OF FLORIDA
COUNTY OF DADE. s
Before me, the undersigned authority, a notary public, duly authorized to Administer oaths and take acknowledgments . personally appeared
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 f• _, • • g application, and that he did sign the same, and that all facts therein by him stated are true.
Permit Na IV 1 / Date 1 1 Read, Sworn to and Subscribed before me.
Disapproved -�� \ � Date
(Signed)
Building Inspector My Commission Expires
DATE
Notary Public, State of Florida
•Chairman Member
Member
Member
Date Disapproved Date
NOTE: A charge of $25.00 will be made for making corrections cc changes to this application after approval has been obtained from the Planning Board.
A re- inspection fee of $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship.
•• •• • •• . • • • .
•••••••■••■••■•
Yo 1<v)
Wfdt tct t.v5
1 PEE z/AN cwwer4
bQJyg &
Ii_v/
.5;fe /
(L Cs 07> IT I kit ki
•••0•••■••••••.■■••■••••••■■••••■•.•••••••••■•■■•.M. •••.• •.•••••••..
•
8 1 7
Ofe=4.1....e*J■now
0•••••■••••••••••••■•