DRIVEWAYMIAMI 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 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 / D No. / C Street if/ 98 S 7_ -
Registered Architect anchor Engineer
Name and address of licensed contractor ----S4A1 City QC4;0 •Q -'LS -i —G • 73. C -s t.) • Y; /1---, `.) /4 «/",' ‘, •-/'
Location and legal description of lot to be built on: %/ — 3 A ° 'S- ° 3 a -- 4.-1 O 4.-1 5 O G
Lot L Block Subdivision X t . 1 e / Y i< •
/ Y.3 /V• ' 98 sr f
Street and Number where work is to be done
State work to be done and purpose of building (by floors). state exterior colors (submit samples) //� �}'
/r—d G�t�G -cam 'd / �C s.7G --y (, J / lt )9p c o& c, ( vim' -i yh G C d /lc •/' eg
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roo Covering
l ' • Estimated Total cost of improvements 5 ` � � Amount of Permit S
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
1 hereby submit all 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 obligatons 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 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 subcontractors. on work to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Signed) �"
7.27
STATE OF FLORIDA
COUNTY OF DADE. } ss.
Before me, the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments. personal] appeared
to me well known.
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 foregoin: application, and that he did sign the same, and that all facts therein by him stated are true.
Permit No. Date
Date
Disapproved
Building Inspector
(Signed)
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved
NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtain:.: frog: the I'(er:ning Board.
A re- inspection fee of S25.00 will be charged when such re-inspection is made necessary by improper notice for inspection or and or workmanship
oi
PLANNING BOARD DATE
- (0050
Read. Sworn to and S '.scri. before
/ /.,
My Commission Expires
Date // 19 7o
Notary Public. Stag ,•t Florida
NOTARY PUBLIC STATE OF FLORIDA
■Y COINISSIOLEXP,_ROY 21,1990
BONDED TNRU GENERAL INS. UNO.
• r\
ild90
Date
3.50' r4 q ' o' 6o.oto
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N
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L . c. a, s. 2Es
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v
ALLEY.
23,60'
Porch . V
\ / -°' 's•o8
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
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specifie not. A copy of
plans and specifications must be kept at building during progress of the work.
D 19
Owner's Name and Address / `D 3 Z'No / u Street
Registered Architect and /or Engineer.
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done
State work to be done and purpose of building (by floors)____
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Chairman
Member f /
Member
Council Approved Date
Subdivision
9
the build -
of Miami
rules and
approved
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of fatipp Roof Covering
Estimated Total cost of improvements $ 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 pennit 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 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 subcontractors, on wprk -tQ be perform under this
permit as are licensed by Miami Shores Village. _
Remarks (Signed)
ing Inspec j9r
PANNING BOARD DATE
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
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-t1ie foregoing application, and that he did sign the same, and that all facts
therein by him state are true.
Permit No 2 L ___ Date
Disapproved (" Date_.
(Signed) _. __lN
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
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 81.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
" 620-CK_
MIAMI SHORES VILLAGE, F
BUILDING IN
ELE
PLUMBING ❑ PERMIT N
ROOFING
Own ��
Building of � � /().
4111..4.0
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
/(5i "?' 9.F�
This permit is granted to the contractor or builder named above to
tion herefor in strict compliance with all ordinances pertaining thereto and
plans, drawings, statements or specifications that may have been submitted
at any time if the work is not done in compliance with such ordinances or if
permit is granted is the understanding that the contractor or builder named
regulations pertaining to the work covered hereby whether shown on the pl
sibility for work done by his agents, servants or employees.
t .
CONTRACTOR OR BUILDER
484
Work to be performed under this P er
Signed:
Subdi-
vision
Value of .Amount of eV
Project $ II Permit $
truct the building or to install the equipment or device docritnailin Alf .piiea-
the understanding that the work will be performed is compirannie . r >, °r any
o and approved by the proper manickpai authorities. This Permit tomr ha remind
the plans are changed without authorization. A further condithm 4pati4lktah This
above assumes the responsibility for a thorough knowledge or rbti : etaVEnCeS t!
or dra'; ings or the sta or specifications and.sbat;lie assumes myosin
,
:
r iiii
: / /.L.. ..a BY:
NSPECTOR
BY
ORIDA
DATE. 7 - /+
comrade 7_
License No.
AUTHORITY
In conside
pertaining theretp a rj In ormit y� with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ae•
cepting this petit Mass 1 T all ork dons by either, myself, my agent, servant or employee.
i nonce to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
t
*SOOT PRINT
MIAMI SHORES VILLAGE, FLORIDA
VATS
BUILDING ❑
ELECTRICAL ❑
PLUMBING ❑ PERMIT N. 294
ROOFING
— Pt1 v a .a? t• ❑
Owner of
Building C L 4 r - s
Architect
Contractor
4111,
or Builder a - -" s J s 0--r 1 7*
Legal Lot
Description I I 131.
- !
Address of
Building 10 d. IS
Work to be performed under this Permit_
4 J"
lt3
Subdi-
vision
Value of � « Amount of
Project $ II Permit
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 appliea-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work ,will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper music'; = <i aaithoritses. This Permit =: "' %i' he. revoked '
at any time if the work is not done in compliance with such ordinances or if the plans are changed without avth =. 4 further condition upon which this
permit is granted is the understanding that the contractor or builder named above assume the responsibility f•.; a th= ough knowledge of the oeditrances and
regulations pertaining to the work covered hereby whether shown on the pia or dra s or in th eraent or specifications and that he assumes respone
sibility for work done by his agents, servants or employees. /
Signed re, BY
BY
Contractor's
License No. T 1/41 C
INSPECTOR
In consideration of the issuance to me of thin permit I agree to perform the work •v= reunder in compliance with all ordinances and regulations
pertaining thereto and in strict c .. ity with the Asp, drawings, stgtefents or specifi • tf <t., eu` ed to the proper authorities of Miami Shores Village. In ac•
cepting this permit I assume ns'•lily for all work done by either, myself, my age employee.
r r
AUTHORITY
a
A•9OT PRINT