AWNINGS52554
MIAMI SHORES VILLAGE
BUILDING PNSPRCTJON p EPARTMENT
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 ma a in compliance and conformity with the Bui ding Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, ll 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 pro✓ ;rmN of the work.
Date..._ Jane 211 , 1973
Owners Name and Address Broadway ,.Gorp9 ;atjor - N 1032 ... Street . E....F. 9P ctre ?t
Registered Architect and /or Engineer Carr Smith & Associates
Name and address of ilcenaed contractor
INC. 741 N. W. 54 Stree, 'la
Florida 127
Location and legal description of lot to be built on:
Lot. . Block Subdivision
Street and Number where work is to be done 1032 N. E. .28 „ treet,, ! a 2i S
State work to be done and purpose of building (by nom). aluminum fold - dates a nil? ..X..L.
and for no other purpose.
New Building.. . Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation..- . „.... Roof Covering
Estimated Total cost of improvements $..Z&).._ ._ 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 �re ld on? ?o d ges : Cl J INC. 741 '1. �^T L� Street ^� iarii a lori! •
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as in employes
of labor under the Florida Workmen's Compensation Act, being Section 3988, Compiled General Laws of Florida, Permanent seem`,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by h
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 sucl� contractors, on work 1t9 be performed under this
penult, as are licensed by Miami Shores Village.
Permit No.
Disapproved
(Signed )
Chairman
Member
Member
Council Approved
Date
Building Ins ' ector
(Signed)_.
5.00
STATE OF FLORIDA,
COUNTY OF DADE. f ss •
Before me, the undersigned authority, a notary pubic, duly authorized to administer oaths and take aclmowledgments, personally ap-
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described cons ction, that he has carefullyead)147e foregoing application, and that he did sign the same, and that all facts
therein by him stated t l 1 23'
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires..
PLANNING BOARD..... DATE
Member ......_....
Member
_..._ ...... Member .. _. ..... .
Pate pisapproved
NOTE: A charge of $1.00 will be made for nlgking cottectinit; p/ changes to this application nftpf app pval
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice
materials and /or workmanship.
to me well known,
Date
has been obtained from
for inspection or faulty