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BUILDING
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SHORES litrAMI VILLAGE, I" LO '
DATA :-
N9 7155
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License
Applicat on is hereby made for the approval of the deta;I,:d statement of the plans and specifications herewith submitted for the build-
ing o. other stru ture he ein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores V-ltag', F onda, and all provisions of the Laws of the State of Florida, all ord'nances of Miami Shores Village and - ll rules and
regulations of the Building Division cf Miam Shores Village sh 11 be con plied with whether her In specified cr not. A op of approv d
pions and specifications must be kept at budding during progress of the work.
Owners Name and Address _ R 5_ J. G„__ M E L Nit Lt..
t
Registered Architect. and • or Engineer ` _ ' __
Name and address of licensed contractor K/_►_i•- t_ t A1114.
_�A V 1416► ___
Location -nd legal description of t to be built on:
Street and Number where work is to be done_
State work 'c be done and purpose of building (by floors) _ __,__. _
?AEI c �RCU�A� DRxve
_ _ . _ _ _ _ ___ /7 _ . and for no other purpose.
New Building _ __ ___ _ Remodeling . _ ___ _ _. _ Additi' . Repairs __ _ _ _ ._ No. of Stories
To be constructed of _ _ Kind of foundation _ _ Roof Covering
ZS�
Estimated Total cost of improvements $ 3 9O _ _ _Arno r is c Permit $
Zone cubage required_ _ _ __ _ _ _ _Plan Cubage _ __ _ .
Distance to next nearest building_ . _ __ _ _Size of Building Lot __ _
Maximum live load to be • me by each floor
I hereby submit all the plans .d s o sa'd Aiding. All notices with relerence to the building and its con: tr.;ction may
be sent to _ _____ _ __ _ _
The undersigned - pp.''cant for this building permit does hereby certify that h , understands and accepts his obligations as an employer
of labor under the FL:rida Workmen's Compensation Act, being Section 3966, Compiled General Laws of Florida, Permanent Supplo.nent,
and has complied with the p.- -v'sions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to b:; } rformt d u der this permit; and will post or cause to be posted for i spection on the site of the work such public notice
or notices as are required by the Act. The undersigned agree- to , ploy only such sul +ntractors wor o be .e formed under th s
permit, • r are licensed by Miai. Si , e Village. _ ,� -
Remarks - ( Sign,. ) 1 ' "� �`�' ._
STATE Ur. FLORIDA,
COUNTY OF DADE SS.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Before me, he undersigned authority, a notary pub]. ; duly uthorized to administer oaths and take acknowledgments, personally ap-
peared -- -
and who, being by m fist duly swo•i upon oath daposes and says that he is the _ _ _
of he above described const u Lion tha. ie has carefully read the or 'going - cat.on, and that he did sign the same and that all facts
therein b . him s' ated are try e-
Per it No. _ _ _ _ I _ Date_ /' Z o
Disapp o ed lY )-W-
(Signed)
Buil..,g Inspec or
_ Subdivision_ _ _
98 S.r
Date_ - __ - -, /\i AW.1/ ?"-°) 19 GC,
No.. __ -_ °, 1 1 . _ Street__ to E 98
Read, Sworn to and Subscribed before me.
Notary Public, St to of Florida
My Commiss on Expires _
•
_ __ to me well known,
PL ING BOARD . _ - _ - DATE
Chairman . Member
Member Member
Member _ M ber
Co,* � ;il Approved Da.e D sapp.oved - Date
NOTE. A charge of $1 00 will be made for making corrections or changes to this appl cation after approval has been obtained from
the Planning Board
A r -i. _pe_' fec of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
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