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MIAMI SHORES VILLAGE re "' t ". - 1421111- f
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 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.
Owners Name and Address (.a./../, .t1i . .... ...._ —
Registered Architect and /or Engineer C 74 �� t�t .bees? .e.
Warne and address of licensed contactor 4l,[tei!zZ- ... /..�..._ /4 4P/Lies?
Location and legal description of lot to be built on:
Lot 6 Block............7
ilf
Street and Number where work is to be d
State work to be done and purpose of building (by floors)..
Estimated Total cost of improvements $ S vdv
Permit No. 14 ' ( i s
Disapproved
(Signed)
4,
STATE OF FLORIDA,
COUNTY OF DADE. ss
Building Ins or
Chairman
Member
Member
Council Approved .. Date
Subdivision / t?1.t...SL &&-A-- . Q
f 5 tf �. cft'c MC ._.. /36.4) n
....... .and for no other purpose.
New Building N Remodeling Addition Repairs No. of Stories zoo
To be constructed of C Kind of foundation COdici4e,,t Roof Covering �f1e. ............._..�
^mount of Permit 3.
..Plan Cubage
Size of Building Lot
Date..._... v..�.t11 ��._.__._......__....._.. ,19..�.y
Streetr-4?6 Zoo . /I ,
err. .fsr. •!:
ecy„,Z.safi 6 w ° 5'3 a /44
Zone cubage required ._
Distance to next nearest building oZ�
Maximum live load to be borne by each floor
I hereby submit all the plans an specifications for said building. All notices with reference to the building and its construction may
be sent to..... /..y_/, etR/
.q, A SCA) :• ( t ) ves f — )c. L to et) .11 A=1 /yam 474 Ale. .?Jo / y
The undersigned applicant for this building pennit does hereby certify that he understands an4 accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General ws of Florida, Permanent Sup`mlcment,
and has complied with the provisions thereof, and will require similar compliance from all contrac s or sub - contractors employed by hire
in the work to be performed under this permit; and will post or cause to be posted for inspection the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractor on work to be performed under this
pennit, as are licensed by Miami Shores Village. t e
Remarks (Signed) /'�
Before me, the undersigned authority, a notary public, duly authorized to administer oathf land take acknowledgments, personally ap-
peared �•
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, anti that he did sign the same, and that all facts
therein by him stated are true. -/
Date 1 ` �' !� `f Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
ANNINC BOARD DATE
to me well known,
Member ....... ..................... —..__ ......
Member ......._....__.._....._...._
Member — .... —.._ --
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 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
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MIAMI 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 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 ...14J.111et.m. 0 _ No.. .. _ . StreetAX. c1: �T
Registered Architect and /or Engineer
Name and address of licensed contactor Q.WA I — _
Location and legal description of lot to be built on:
Lot 5 Block - 7 - 7 Subdivision. Pi r ,'.! :x:1.1 ..Skiat1'r .. ...
Street and Number where work is to be done q'F. AiE q Z. eS T
Ste_
State work to be done and purpose of building (by floors)...s.5.. , ?lttiade - s y. S .. ikett.__. ._r'1l LL r
STATE OF FLORIDA,
COUNTY OF DADE. ss
Disapproved
(Signed) D
B uilding Inspect
PLANNING
Chairman
Member
Member ...... _.....__..
rr
E7 c
and for no other purpose.
New Building ✓ Remodeling Addition
To be constructed of Kind of foundation / Roof Covering
Estimated Total cost of improvements $ .�..
Repairs No. of Stories
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 employer
of labor under theFlorida 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 subeey(tractors, on work to be performed under this
pennit, as are licensed by Miami Shores Village.
Remarks ..._ (Signed).
OARD
Member
Member
Member
Council Approved Date Disapproved
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 state are true. //
Permit No.__..___ . Date [' � / 7 .- Re d, Sworn to and Subscribed before me.
Notary Public, State of Florida
My ission Expires
DATE
to me well known,
Date
application after approval has been obtained from
NOTE: A charge of $1.00 will be made for making corrections or changes to this
the Planning Board.
A re- inspection fee of S1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.