SCREEN PORCHBUILDING INSPECTION DEPAPTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed statc,,,cnr ur me plans and specifications herewith submitted for the build
inc 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. a QQ
(75-4.4- / t Date Q ^ � , 19. 0
Owner's Name and Address .. /
Registered Architect and /or Engineer.....
Name and address of licensed contactor .... l£i.CC elit1.0 ?.5. • 0"Z" /
on an cga �
Location d legal description of lot to be built on: / / 3osa /s' ° h
Lot
Street and Number where work is to be done. 7 . .�.....���� .q. 40% ..____.. .._._.�
State work to be done and purpose of building (by floors) a C.v ortc
-3 Block e 8 0 Subdivision.,./4111....5 fit - J ...11 6' .E.ed!:
and for no other purpose.
Ncw Building Remodeling Addition..( Repairs No. of Stories �- j
To be constructed of Kind of foundation . Roof Covering 44././1...4p...Q 4�l/
Estimated Total cost of improvements $
Amount of Permit S..
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..
Building Inspector
Chairman
Ucrnber
Member.. .. _.....__._..._..._._ ...._.......
Council Approved Date
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials anti /or workmanship.
MIAMI SHORES VILLAGE
PLANNING BOARD DATE
Notary Public, State of Florida
My Commiuion Expires
& %7
AaV (6? s r, cl .? ' ` ors
The undersigned applicant for this building permit dots 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, PetinAnent 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 arc required by the Act. The undersigned agrees to employ only such ntractors, op work be performed under this
permit, as are licensed by Miami Shores Village.
Retnuks (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 arefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are tru . t e
Permit No.._.!�lr/. k'l Date 1 " 9/4 $ Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Member
Member
Member _.._.....
Disapproved Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by Improper notice for inspection oe faulty
ElliarniarbOreS91ilage
F L O R I O A
PLANNING BOARD AGENDA OF 1/4115t4 0 ) 194 ITEM NO. 3
7.lCCAR1 C-014S CO. (AI — 7093
Name of Owner /Applicant 1/41O141W 1)030 IS Phone No.
Address of Property, and /or Legal Description 1 7 9$ ST.
Nature of Request APPROVAL. OV PLAN9 rOcio 3R.-4 •6RCN A_DD1
Present Zoning R " xO
Area of Present Building Vilh•3
Area with Proposed Addition tq b 9
Parking Spaces Provided
Parking Spaces Required with Addition
Setbacks as per Code
Setbacks Provided
Vari ances/Exceptions/Zoni ng Change
Ft1..L,O' ffi3t oat 'RI% P,QD'9 = 300 4
?RO Plssi) n 4
Council Action Required NO
Date of Applicant Notification
Planning Board Action
Council Action
Aatm)
Director of Building and Zoning