WOOD DECKs
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby nude 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.
FRAIL/it /1f�n
Owner's Name and Address /—,1W/ t'r,! : i ..._ No. ._.. StreeC::!_ l L
Registered Architect and /or Engineer ��77-- p /
Name and address of licensed contractor...: :.Nt7:�r. +"r lP. v AJ IJ 1 P"c P. al: g4.FL..L. - ::
Location and legal description of lot to be built on: e
Lot f'2 Block `4 Subdivision l4 L 4 lC.L •C 8I
Street and Number where work is to be done PS O A E F
State work to be done and purpose of building (by floors)
a
, ;
and for no other purpose.
New Building Remodeling i Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 5 % Amount of Permit $,.... e 6Q
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 the Florida 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 sub- contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for ins ection t site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su tract work td2be perfgrmed undee
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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 stated are true. fI IIyy�
Permit No. __ k®l [ _ Date._ !_�I.6 Read, Sworn to and Subscribed before me.
Disapproved _ Date Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires
to me well known,
PLANNING BOARD ..... .DATE
Chairman Member
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 at faulty
materials and /or workmanship.
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/,ME/VOED PLz1T
M/4 MI SHORES, DLIDE COU/(/T) F[OR /DA
Accordi: :g to Pat /O Pace 7 0 o
the Public Recr:rds of D de County, Fla.
SURVEYOR'S We hereby
certify that the attache'. "Sketch of Sur•
vey" of t! above descr :5ed property is
true and correct tc `` . _ ^st of our knowt. •
edge and belief - rec l`.i; survc
our direction.
DONALD W. MCINTCSH' & ASSOCIATES, INC.
Reg. Surveyor -..1-3 . _ State of Florida
NOT VALID UN r =03 SEALED
ELEVATIONS SHOV. N THUSLY . 12,7
ARE RELATIVE TO THE NATIONAL
GEODETIC VERTICAL DATUM OF 1929.
DONALD VI 6'cINTOSH ASS -0OIATF , INC.
581 N. E. 91ST ST.
. MIAMI SiPRES, FLA. 33138
DEC./ C5 78 -553
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M/L M/ 5 HORES 5ECT7ON ONE
ME/tlDED PLAT
`M /4.A4.1 ..5HORES, DADE .COUNEY .FLOR /DA
According to Plat Book /0 Page 70 _ 00
the Public Records of Dade County, Fla.
SURVEYOR'S CERTIFICATION: We hereby
certify that the attached "Sketch of Sur•
vey" of the above described property is
true and correct to est of- -our knowl-
edge and belief lt!y surve d r
our direction.
DONALD W. McINTOSH' &ASSOCIATES, INC.
Reg. Surveyor_ai State of Florida
NOT VALID UNLESS SEALED
ELEVATIONS SHOWN THUSLY .x 12
ARE RELATIVE TO THE NATIONAL
GEODETIC VERTICAL DATUM OF 1929
DEC 41978
DONALD W. McINTOSH ASSOCIATES, INC.
581 N.E91STST.
MIAMI SUORES, FLA. 33138
C5 7 -553
REMARKS:
FIRE DEPART :_9E„i
PUBLIC WOR„S
VILLAGE
PRELIMINARY:
POLICE DEPARTII.E •I F
BUILDING DIRECTOR
PLANNING & ZONING iJO •'
11 ECHANTS'
CAM E II TiE PROPER
PAYll 1G 1■IC FOR MEE
LI R U 6Vd1S00 0 ." •
J ..E .- SJ ;,:C 0.= A BUILDING PERMIT
9 L1 h.ITH "0 IT'i °I;1 "CE':) L'STED IN "REMARKS"
NO OT' +ER "E '! " :I'O "' S ' P,ES BUILDING AND ZONING
ORD:::AN: ES 4 :1' I. SE ' _E •;:: SPECIFICALLY LISTED BELOW.
AI.I OTHER APP IC ^g' E ;'i'.TE D ;:OU:;TY LAWS MUST BE COMPLIED
ITH
BY ALL PARTIES.
S an2ture Date
APPROVAL
FINAL:
COMPLIANCE WITH THE SOUTH FLORIDA BUILDI 1G CODE AS ADOPTED
BY MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER &
SUB CONTRACTORS r O I
ING REGULATIONS WHETHER OR ( NOT SPECIFICALLY INDICATED HEREIN.