1158 NE 99 St (4)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 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.
Date February 21 , Is 69
Ownpr's Name and Address._ Fair • _ Frank 0' Hare N 1158 s tore N.E. 99th. St.
RegWtered Architect and /or Engineer
Name and address of licensed contractor_ Calumet Windows, Inc. 1002 E. 24th. St. Hialeah, Fla. 33013
Location and legal description of lot to be built on:
Lot__ Block _ Subdivision
Street and Number where work is to be done___1158_ .E_.___ 9Qtilla__,4t e.e t M JII.L__ 5hores_._E1..__ _
State work to be done and purpose of building (by floors) Replace 21 existing steel windows with aluminum
awning type windows. No structural c
and for no other purpose.
New Building Remodeling__ EX__. Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering__
Estimated Total cost of improvements $__1075..00 Amount of Permit $ 7_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 foi said building. All notices with reference to the building and its construction may
be Sent to___Calumet Windows„__ Inc._ 1002 E. 24th. St., Hialeah, '1a.
The undersigned applicant for this building permit doe 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, Pennanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contracto or sub- tractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection o e site of he work such public ice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, n work b be performed and his
permit, as are licensed by Miami Shores Village. ,' �� ��
Remarks - -- (Signed) c (J �' I\-
STATE OF FLORIDA,
COUNTY OF DADE. Ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aLknowledgments, 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._ -- --O ZT � _ t � - - __ Read, Sworn to and Subscribed before me.
1- _ -- Date- .t- - -.>.�
Chairman _.
Member
Member .
Council Approved
Disapproved ____ _ _ _ ._ ___/_�_
( Signed) E lige-
Building Inspector My Commission Expires.
ate
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.
Notary Public, State of Florida
PLANNING BOARD__ _.. DATE
Member
Member
Member
_Date Disapproved .__ ..
Date