MECHANICALApplication is hereby made for the approval of the detailed statement or ute 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.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Disapproved
(Signed)
APPLICATION FOR BUILDING PERMIT
Building Inspector
eIbG. PGre.•
1r - ZZzt;2.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date
Date..._ V - 1 . / ,2......___.
&Amer's Name and Address M 1 M M � & O S A -- --, No.... .� _... Street) £ 9 V She ct
Registered Architect and /or Engineer ,,,,. 111...7 ... ........................,
-
Name and address of licensed contractor.. LBe f2T 1 12- CO /J.D I TI ON 1 N G 5 IJ . (.t' . 3 S- -e i- /U f obi t
.
Location and legal description of lot to be built on:
Lot et et Block 1-7 3 Subdivision M t A-M
Street and Number where work is to be done /0 4 S k.) t C- - Q $ e e
T - --
State work to be done and purpose of building (by floors)..t.1...i�zS L ..II a 4 se &.
et h - - I iA �S a atJ .t ; 7 N iNC
...-iis - le-t•><7 _..._ 1 N Q h il D D . 1 - t - t 0,s ..._ ck. S / i 6 L E Fa nit </ 2 e s i t7 e Svc e.
and for no other purpose.
Ncw Building Remodeling Addition X Repairs No. of Stories
To be constructed of Kind of foundation a Roof Covering
Estimated Total cost of improvements S 1 i 10 Amount of Permit $.. 13444
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. M1 notices with reference to the builg and its construction may
be sent to kL3EQr'S Ate_ CN1IriO JI JG abeP- S)Oi 0.0- 3 5 ,' 114/4ILl1 f....
i4L
S 4Oi? S- S " 13
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an emploPeA
of labor under the Honda Workmen's Compensation Act, being Section 5906, Compiled Cei . ws of Florida, Pennanemt Sop clement,
anti has complied ssith the provisions thereof, and will require similar compliance from coatracto or sub - contractors e• . . by him
in the work to be performed under this permit; and will post or cause to be posted for ' spection on t e site the work ch pu lit notice
or notices as are required by the Act. The undersigned agrees to employ only such s •ntractors, o or - o be pe ormed der this
permit, as are licensed by Miami Shores Village.
Rem.uks . (Signed )...._...
,, 33 t��-
A-LB27 PcieEz, PR
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 the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No.. 2.3 Date I. 1 " 1 3 -70 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commiuion Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member .. .. _ ..... _ _. . . .. _... _.�........... Member
Council Approved Date Disapproved W Date
NOTE: A charge of S1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Pl,rnnir.;; Board.
A re•mspection 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.
B UILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor `,
or Builder . 1 . 1
Legal Lot
Description
Address of
Building 1° 4 .17
0
0 PERMIT N° 4154
0
CONFRACTOR OR BUILDER
EMI SHORES VIIJUkieta FLORIDA
lf�T
Co*t ctor
License I4.
trokb
This permit is granted to the contra tSIT er
don berefor in strict compliance with all online
plans, drawings, statements or specifications that
at any time if the work is not done in compliance
permit is granted is the understanding that the .coat
regulations pertaining to the work covered hereby whether
sibitity for work done by his agents, servants or employees;
Work to be performed =der t Permit
10 1'= trx
e d above
v eto and
brained
or if the plass
named above assumes
on the plans or drawings or fe
Signed'
In consideration of the issuance to me of this rsert# 3 agree to perform the work wend hammier
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted... to the
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employ,
BY
rites
AUTHORTI7
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 ._r1�
Registered Architect and /or Engineer /,
Name and address of licensed contractor_, �d� __/ xtiGirC- 9f--- CO._ 1_ 44,__ -'79.
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done ___ -
State work to be done and purpose of building (by floors) _
Building Inn ector
MIAMI SHORES VILLAGE
Date.- - . ,, 19,
No I NO Street y1J
1
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 $ " 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 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 sit .f the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such�subco tracto o be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
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 lie has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are e.
Permit No S f Date d �j Read, Sworn to and Subscribed before me.
Disapproved
(Signed) .. _
Notary Public, State of Florida
My Commission Expires
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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.