1119 NE 99 St (4)•
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Amount 7Fi Q`� r P ---
No. Houses
Issued
Address
KNOW ALL MEN .• Y
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in consideration of the issuance
or buildings at t se folio ; ing ad
INSTRUCTIONS TO BUILDER•- .Whert
Village Building Inspector and obtain hie approv
V
I hereby certify that the cons
caused the surrounding premises so
WHEN CLEARED AND BEMIRED gr
Amount of Bond . . .. . . .
Cost of clearing and repairs done by Village
Balance due Builder
±.0 ad 1 i z r• '4 °s
/ / O / 7
BUILDER BOND
PRBSIONTS, the I,
t/1let
Miami Shores Village, Florida, of a permit o permits to construe
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do hereby deposit with Miami Shores Village, Florida, the sutn of go •••• , and I agree :wit said Village that, aatiCit.conetruction ehali
have been completed by the, within the cousin of the +emiinences of said Village, I will dear � premises and repair any V ertq damaged by me,,
used for the deposit of material or equipment in the co N �� wq or repair arid- ther,�if4 di to aieac and repair such premises immediately upon the
completion of such consrruc4n williectles meaning of 7s , doe Village may ChM and repair the same and pay: the egssikeinsch eleamile see
repa, out p the aforesaid lb 1 "`" t'dnd icing theirglgihderto.me Ond *ant, if I shall cl ear and rep said prep y a's afarmaid ALse
said .PS shalt be returned to me.
WITNESS MY ITAND and Sole ho nes llIage, loridb : .�S y:1--
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593
pair a building
Sr_
tistreetiou ie completed :cud eke P cleared and repaired a this bond to the
Miami Shores Village will refund your mo a in accordance with the above agreement.
LEITW RISNICTOWS AIM RpvAL
**nig* Simut has keen completed and that the builder thereof has
nstruction.
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
Registered Architect and /or Engineer 4 km �f ee_e No. ___ S treet _7__10 /
i— q
Name and address of licensed contractor IVit1
Location an galdescription of lot to be built o
Lot __ Block — _ Sub 'vision____ /__II005: Cr __er
Street and umber where work is to be done ID ___ fr,frni
.S
State work to be done and purpose of building (by floors)__ '_'!_/l!�f4 r a
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI SHO VILLAGE. 1(3/12
BUILDING INSPECTION DEPARTMENT
6 S •
APPLICATION FOR BUILDING PERMIT
Disapproved Date
(Signed)
Date UL e • 1-
Notary Public, State of Florida
and for no other purpose.
New Building ' Remodeling . AddSl'lion Repairs No. of Stories__
C
To be constructed of____ +.? Kind of foundation__ s � -O.l ^ • �
Estimated Total cost of improvements $_ 1__ • • Amount of Permit $ /�[ p
Zone cubage required ^�f__QQ a _Plan Cubage /` 0 a fr
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
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 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).
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 q 7 Date 7 - /J Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman ember
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 or faulty
materials and /or workmanship.
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