ROOFINGMIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
.Application is hereby wade for the approval of the detailed statement ur vie plans and specifications herewith submitted for the build
ins 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.
Date
9-3 _ ,1981_
P . Freeman 115 �_.._ NE 99
Owner's Name and Address _ No Street
Registered Architect and /or Engineer ,,,,,,,,,,,,,, „,,., „,... „, . _. ....
Fame and address of licensed contractor Andrews Rf g . Co . 4300 Ell Ave Hialeah, f1.33013
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 1151 NE 9 9 S t
State work to be done and purpose of building (by floors) Remove present roof, Replace any bad wood,
_..__ and for no other purpose.
Ncw Building Remodeling Addition Repairs X No. of Stories 1
To be constructed of hind of foundation Roof Covering tile
Estimated Total cost of improvements $ 6,96M0 Amount of Permit S. 2D,00
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.. Andrews 'Rfg, 4300 E 11 Ave.. Hialeah,, F1.33013
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, Perinanent Siip element,
anti has complied ss ith the provisions thereof, and will require similar compliance • all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be post 3 fo inspectio on the site of the work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only s h su• antra ; .rs, on yoSk to • - rformed 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 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. Q
Permit No D `3 0__( 4 Bate c 1 - 3 ” °� Read, Sworn to and Subscribed before me.
Disapproved q. . ! ..._ late Notary Public, State of Florida
My Commission Expires
Building Inspector
PLANNING BOARD DATE
Chairman Member
Member Member
Member . . Member _. - -_.
Council Approved Date Disapproved Date
NOTE: A ch.Irge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the I'Llnnir,;; Board.
A re fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection ore faulty
materials and /or workmanship.
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 Law of the State of Florda all ordinances of Miami Shores Village ?nd all rules and
regulations of the Building Division of Miaml Shores Village sh.a1 be co :,plied with whether herein specified c. 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/
STATE OF FLORIDA,
COUNTY OF DADE. ss
Name and address of licensed contractor
' ngineer
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done // / { e
State work to be done and purpose of building (by floors)._
1 :
and for no other purpose.
New Building _ .._ Remodeling Addition L--- Repairs No. of tories
To be constructed of Kind of foundation Roof Covering_____
Estimated Total cost of improvements $ -___ _ Q _ __L_. Amount of Permit $ -..- _
Zone cubage required____ _Plan Cubage
Size of Building Lot _ ______.
Distance to next nearest building
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, be' g ction 5966, Compiled General Laws of Florida, Permanent Supplement
and has complied with the provisions thereof, and will requird sim ar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or ca se 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 em oy only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)_ s__ C•____ ____
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 ue
d are true.
No • loo. -- -- - -- Date.___ __ 1__I _ I S___ Read, Sworn to and Subscribed before me.
Disapproved __ Date
( Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
AY'
Date_
____ No. / L'l ___ Street__
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD __ _ DATE
Chairman ._. __. ___ _ _ _ Member
Member _ Member
Member A Member
Council Approved Disapproved
- - - /a- - 19
Q.t�S ✓ CIL
to me well known,
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. 1 1
BUILDING 0
ELECTRICAL 0
PLUMBING 0
ROOFING
Owner of
Building �` l c..� - I��•+'
Architect
Contractor
or Builder
Legal Lot
Description II B1,
Address of
Building
CONTRACTOR OR BUILDER
s V
ita
N. 7005
be perhormed under
This permit is granted to the contractor or b uilder shamed trove to construct the bet
tion herefor in strict compliance with ati ordilaaaces perm; nin thereto and with the
plans, drawings, statements or specifications the may have submitted to and approved
at any time if the work is not done in compliance with such ordlaa oes or if the pbtn ere changed
permit is granted is the understanding that the contra# tar or bidder teamed above assumes the roe
regulations pertaining to the work covered hereby wire er shown oe the plaits or drawings or in
sibifity for work done by his agents, servants or employees.
Value of
Protect
Amount of
Pmt
Signed:
In consideration of the issuance to me of this permit I agree to perform the wort covered hereunder in compliance
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authors
ceptinq this permit I assume responsibility for ell work done by alter, myself, my agent, servant or employee.
BY
Wt. : e• =i r i ' ct3 ' !
s eat or device descend in the
be performed in eintiviiance with any
des. This Pernik raay he revoked
ion. A further cond om t olf which N
er a thoro gh knowledge of sea -r
or specifications and that be OSIPLIffiea respon-
AUTHORITY
ASIOt