3876MIAMI 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 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 Shores Village and all rr}les and regula-
tions 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.
W13- 0 Y I S 81/T>vi2, .3 Dam ! �'� , 191
Street 9{
r 164 t-Newp c? A .1 x1.3 j _
Owner's Name and A
Registered Architect and/or '
Name and address of licensed contractor 2 + *N t i i. .
Location and legal description of lot to be built on:
1.0t 49, Block 6/ subdivision jn.. $ ,, — ..n.rt./
Street and Number where wOrk is to bed � �'.
State work to be done and purpose of building (by floors) _ 12/ TJ n� + LL'U a$ y` - t5 Y 1747
And for no other purpose.
New BIIilding R emodeling addition L Repaint . No. of St rit*
To be constructed of C• Kind of foundation vf .° \ Roof Coveting
Estimated Total cost of improvements $_24 4 : 9 0 1 -. 1 Amount of Permit $
Zone cubage Plan Cubage
Distance to next nearest building Sin of Building Lot
Maximum live load to be borne by each
I hereby submit all the plans and specificationt- for said building.
be sent to
L4*
vent
,b
� II
The undersigned applicant for this building permit does hereby, certify that he understands nd accepts his obligatio an employer
of labor under the Florida `Workinen's Compensation Act, being Section 5966, Complied General Laws Of Florida, P pplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors • by him • i the work to be performed under this permit; ,and will post or cause to be posted for on $ite of the work p + c notice
or notices as are required by the Act. The un der i gned agrees to employ only such sabeon ! , > . n o / l e perfo , ed der this
permit. as are licensed by Miami Shores Village. �� � / J
� .
Ij
Remarks N (Signed) 4I 14
STATE OF FLORIDA, I
COUNTY OF DADE. ss.
Before me, the t pthority, a notary public, duly authorized
appeared o •
administer oaths and Jake acknowledgments, personally
and who, being by me fust duly sworn, upon oath deposes and says that he is
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 trite. _
Chairman
Member
Member
Council Approved..
e well known,
Member
Member
Member
hate' Disapproved
Gate
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-' on fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials an or workmanship.
r �
•
J ioms9
OR ID
ITre
in consideration of the issuance to me by Miami Shores Village, Florida, of a permit (No b„, i ) to construct or repair
KNOW ALL MEN BY THESE PRESENTS, that I,
a building at or upon the following described property in said Village.
Lo r Blv
�D
do hereby deposit with Miami She Village, Florida, the sum of fty Dollars ($50.00), and I agree with said Village that, when such construction shall
have been completed by me within the meaning of the ordinances of said Village, I will clear all premises and repair any Village property damaged' by me,
used for the deposit of material or equipment in the construction or repair and that, if I do not so clear and repair such premises immediately upon the
completion of such construction within the meaning of such ordinances, the Village may clear and repair the same and pay the costs of such clearance and
repairs out of the aforesaid Fifty Dollars, and return the remainder to me; and that, if I shall clear and repair said property immediately, as aforesaid, th
said Fifty Dollars shall be returned to me.
WITNESS MY HAND and Seal at Miami Shores Village, Florida, this
I hereby certify that the construction contemplated under Building Permit No
'• ` that the builder thereof has caused the surrounding premises to be cleared and repaired •
commencing said construction.
▪ WHEN CLEARED AND REPAIRED BY THE VILLAGE
Amount of Bond $ 50.00
Cost of clearing and repairs done by Village . . $
Op
Balance due Builder $ .'6
INSTRUCTIONS TO BUILDER --When above mentioned construction is completed and the prem =. cleared and repaired '"tea. is bond to the
Village Building Inspector and obtain his approval, after which Miami Shores. Village will refund your money in accordance with the above agreement.
VILLAGE BUILDING INSPECTOR'S APPROVA
V Inge
APPROVED:
Subdivision
has been completed and
on as they were before
Village.
Inspecto
• '* i i' •,:l • ..•ittei `° r r•.. • r 0. 1 teM •n .° I •. ..j WI•...•lr ' a . a i `• ° r ' �
BUILDING
ELECTRICAL
- PtF#MBfNG
Owner of
Building
titect
Contractor`.e
g -or Builder- r •
al Lot
scription
PERMIT N° 3876
Work to be performed under this Permit
•
dr-
OR OR BUILDER,"
MIAMI SHORES VILLAGE, FLORIDA
DATE .!;/.$2.,
Contractor's
License No.
BY
AUTHORITY
194 —
"address of
wilding
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
p plication herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed"; in compliance
!th any plans, drawings, statements or specifications thatmay been submitted to and approved by the proper municipal authorities. This Permit may
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
n which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of
ordinances and regulations pertaining to the work covered hereby whether sho on, the - plans oyldsawings or in the statements or- .specific: and
employees. L? p a
.: he assumes responsibility for work done by his agents, servants or Signed 9.., - -. mss �a B t
INSIIECTOR
In consideration of the issuance me o *is permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
pertainng thereto an in strict co ormity vWth the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
e= In t rmit=I ass ponssbility for all work done-by either myself, my agent, servant or employee. �_
Zone Req.Cu. .
Plat Restriction Checke
To Planning Board
Re- Submitted to P.B.
Plans & Spec.' Checked b
To Council
Bldg. • Permit loo.
Type
Alteration
1
teration
`fie = ns 37 ' Ro .Inap
New Construct4on
Plumbing re t, N0
Septic Tank
Sewer
Mis c l 1
New Const
ectr
Fixtures
Heater
Motors
New Construction
Building inspection
Foundation
Beams & Linters
Final
Final Clean• U
Plumbing ape 4 tion °°
Roughing
Fixtures
Sewer
Septic Tank
Solar Heater
Final Certificate
E eo rice pee
Roi,ing
Fixtures
Final
Tem •. O.K.
i ery oe O.K.
by i
_ 7 Approved Rejected
Approved Rejected
Date
Stories
'iterations
e
Approved Re jee' e
Cost _ 1
77/1)
Roof
epairs
Fee
n
airs
Cer .Uesup,
/1