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FENCE• • 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 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. l Date //0-- / 19 U 7 Owner's Name and Address r G a + e L mA d No ) / 5/ Street N P-99 Registered Architect and /or Engineer Q A I J d Name and address of licensed contractor 1 C P 1 l IV l0 /F ,/& Location and �legal description of lot to be Subdivision e built on: // ���� /I" e7O 7d Lot le O Block i !b YY' 4 S(( e S — S e c / r o n F 1 �- f� 2 Street and Number where work is to be done / ) 5 / /! G 99 s �' ,L/ State work to be done and purpose of building (by floors), state exterior colors (submit samples) �L �P- /1 C = 79 'a �� / V./. and for no other purpose. fence_ New •Dkikling ✓ Remodeling Addition Repairs No of Stories To be constructed of C /L ' Kind of €eundation C /L � overing 7 % ? y r / /y Estimated -Total cost of improvements S 75 - x Amount of Permit S jo' oa (a (// [/ 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 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) STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the undersigned authority, a notary public. duly authorized to administer oaths and take acknowledgments. personally 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 foregoing application, and that he did sign the same, and that all facts therein by him stated are true. siyd Permit No. Disapproved Date Notary Public. State of Florida (Signed) 9 Date / / /jD f o 7 Read, Sworn to and Subscribed before me. Pb , L- 3 e7- 6 - 7 Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of 525.00 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 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anchor workmanship. • A • [. J i bUILUf . r t•UNINI AI /MIN1IRA1 PLUI ML•• r • LC G, NI 't' I oval. :.� tc l ut hu. _,., 411. I11.4 A N.. .1 , 11 kK A1'I l 1 , 1'L SuDJ■ mein 14 M I -4; gQd4 L Mrly 0 Ilurnd► g Lt-3 Nuk III Akkl.M 1 THESE PLANS ARE APPROVED FOR ISSUANCE OF A BUILDING PERMIT VARIANCE(S) LISTED IN "REMARKS" P,MIAIMAI SHORES BUILDING AND ZONING UN ESS SPECIFICALLY LISTED BELOW. AID COUNTY LAWS MUST BE COMPLIED Aut 'rori7ed Signature Date • WITH NO VARIA! ;CES • WITH NO OTHER DEVIATIO S F Rr 1 T: ':E ORDINANCES WILL EE Pr'! 'HTTE0 ALL OTHER APP! IC: '3!..E ST•`.TE WITH BY ALL PARTIES. FIRE DEPART: ;ENT PUBLIC WORKS POLICE DEPARTME::V r BUILDING DIRECTOR � � \'/'�''�7 +� � PLANNING & ZONLG t20`..: 4 VILLAGE COUNCIL , APPROVAL PRELIMINARY: FINAL: REMARKS: COMPLIANCE WITH THE SOUTH FLORID1 BUILDING CODE AS ADOPTED BY MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER & SUB CONTRACTORS PPE 'n'! Agri - r' , :Ii ;11r lc . 0W 1 FnfF OF ALL BUILD- ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN.