WINDOWSCorrection
1.4%1'1;440'
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buildi Insp ction Request
Date 17 G e S
Type Insp'n L//'.1/J� / : - L�'.f a
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Permit No. v yz-- —
Name s � o ua
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Address / 6' 2_5 N .G 91 ssi
Company ‘ N
Phone # _ 7 7 /
Inspection Date / �0/ S
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Re- Insp'n Fee ❑
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MIAMI SHOR S VILLAGE
BUILDING INSPIICTI
1
Application is hereby made for the approval of the detailed
ing or other structure herein described. This application is ma
Shores Village, Florida, and all provisions of the Laws of the St
regulations of the Building Division of Miami Shores Village sh
• of lorida all ordinances of Miami Shores Vi age and all rules and
plans and specifications must be kept at building during progress of the work.
Location and legal description of lot to be built on:
Lot_.—D. Block 1 79
Street and Number where work is to be done 1 ° 2 5
be sent to_
Chairman
Member
Member
Council Approved
APPLICATION F
Owner's Name and Address Myron H WilliSOri
Registered Architect and/or Engineer tone
Name and address of licensed contractor 114:17.1214/_.4enodelin.g Corp • 550 N .11 • Ansin Blvd. ,liiiillandale
Subdivision KinneY Park
N.E. 98 Street, Miami Shores
State r to be done and purpose of building (by oon) Window placeme
New Building_ Remodeling CX Addition Repairs
To be constructed ofG
_laS 8 Kind of foundation_ Existin
Estimated Total cost of improvements $..2.1 ... t 00 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 specilkiNitsklmssattnicting-: heticet-with‘rtference to the building and its construction may
C 7-1
550 N. W. ANSIN BLVD.
. . HALLANDALE. FLORIDA 33009
The undersigned applicant for this building p hereby cermy that he understands and accepts his obligations as an employer
of labor under the Florida ,Workmen'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 s ch ublic notice
or notices as are required by the Act. The undersigned agrees to employ only ch subcontractors, on work to under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j u •
Before me, the undersigned authority, a notary public, ciply authori d to administer oaths and take acicnowledgments, personally ap-
peared W I 1.,.. L.- k ?i_k---j. ...• t BS El /■.._)
_P ' LO.J__./E11QL.) ----- (-- Ift> ' LIA-N.3 A LE. i_Fbelt. . ' to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.. (..-N A4- N.36
that - 7EQ Z ---
of the above described construction, at he has carefully read the foregoing application, and that he did sign the e, and that all facts
therein by him stated are Crue.
Permit No. /S7 "C Date.. Disapproved ___ Da e
(Signed)
Building Inspector
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re-inspection fee of $1.00 will be charged
materials and/or workmanship.
DEPARTMENT
R UILOING PERMIT
(?
staten4 t of the plans and specifications herewith submitted for the build-
In ' mliance and conformity with the Building Ordinance of Miami
be omplieci with, whether herein specified or not. A copy of approved
_Date Disapproved
Date . . . ......
1025 SC J . • • alkiei
and for no other purpose.
yr"
No. of Stories 1
Existing
lq?vering
Member
Member
Member
1
making clorrections or changes to this application after approval
when such re-inspection is made necessary by improper notice
Notary Public, State of F1o1da
• My Commission Exp* .coinossioN..Exmagg_Auc,,.4%.4924
CiS STATE 41 FLORIDA of ME
• THROUGH FRO) Yid PIESTS.H011
DATE
Date
has been obtained from
for inspection or faulty
1774 W. Flagler Street
MIAMI 35, FLORIDA
Phones: FR 9 -3508, FR 1 -0027
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According to the Plat thereof as recorded in Plat Book
• Public Records of Dade County, Florida.
For Dj fi r CZfiC :5"
There are no encroac :.:ns'
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STATE OF iLORIDA
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Date „ �E�3 4 %, 6 G'
- 8 /7 /..96/
I HEREBY CERTIFY that the attached sketch represents
e survey made under my direction and is true and correct
REGISTERED LAND .
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