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FENCEBUNG 0 ELECTRICAL 0 PLYING 0 ROOFING s 0 sC' Owner of Building Architect Contractor or Builder Legal Description Address of Building This p herefor in strict c drawings, statements or spec time if the work is not done!: granted is the unders pertainin b the wok cove done by his agents, servatlts or Lot In consideration of the issusame, tae pertaining thereto and in strict conformity` with In accepting this permi I assume responsibility CONTRACTOR OR BUILDER MIAMI SHORES VILLA E FLORIDA 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. �1 7 t 1i.�(!1.. Date- - ._. 1 5 - Owner's Name and Address.. AV - rE� ' ill �1 � No /12 Street__ Registered Architect and /or Engineer _.._ � _. - Name and address of licensed contractor__ .. . t 0 4�4�� MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT • Lam. Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done /, / V , o � State work tq be dope and rpose of building (by floors) k h _t'F / 1 aet c-a' 1 - -- and for no other purpose. New Building_____ Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundat , of Coveri Estimated Total cost of improvements $ S' Amount of Permit $ 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 The undersigned applicant for this building pennit 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 •e site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractor . . work to be performed under this permit, as are licensed by Miami Shores Village. Remarks Signed) .4-- STATE OF FLORIDA, COUNTY OF DADE. J 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 statec4are true. Permit Date___ Read, Sworn to and Subscribed before me. to me well known, Disapproved (Signed) .... - - ilding Inspector My Commission Expires PLANNING BOARD DATE Chairman ....... Member 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. Notary Public, State of Florida 76 9e Owner of Building Architect Contractor or Builder Legal Description Address of Building This permit is granted to the contractor or b der named : ove to construct the building or to stall the equipment or device scrib cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and a • sroved by oilper municipal authorities. This Permit may be revoked n out authorization. A further con4tion u. on which this knowle a of a ;idinances and e a�nsi for a t1Q � . .. aL + suptesrespon- it OAP I agree to perform the wor wings, statements or by either m = - at any time if the work is not done in compliance with such ordinances or if permit is granted is the understanding that the contractor or builder regulations pertaining to the work covered hereby whether show sibility for work done by his agents, servants or employees, In co ' ' eratio ' + ,i suance to - of this pe aining +xe a in i conformity th the e respo CONTRACTOR a 13 IIL R IAMI SHORES VILLAGE, FLORID DATE allak i 9 Contractor's License No PERMIT N? "7412 Work to be performed uynder this Permit INSPECTOR covered hereunder in compliance ifications submitted to the proper y agent, servant or employee. BY AUTHORITY pp and regilati BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is iffy made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing f other sttructute► rein described. This application is made in compliance and conformity with the Building Ordinance of Miami Sho. 'Village, RU A& wad s1l provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Btildiitg Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spiecifi meet be kept at building during progress of the work. ,}� Date I _ , d/j ,19 - - - -- Owner's Name and Address____:aft__SIM/ / 1 C.!_�-_ /_ zie- No.__. 1 7�f Street _ ? _,L_ Registered Architect and /or Engineer f ' Name and address of Licensed contractor i9__Ar',rs?lr Location and legal description of lot to be built on:: Lot - " ___ Block __________L 7? Subdivision_ MIAMI SHORES VILLAGE _e wer Age. Street and Number where work is to be done ____ �a__ 7_ __,G���/�____ «QL.__.__._.._. —__ State work to be done and purpose o building (,by floors)_.°_ ------------------------------------------ and for no other purpose. No of Stories Roof Covering New Building Remodeling__ Addition ''! Repairs To be constructed of Kind of foundati Estimated Total cost of improvements $ 45V Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot_ e� } '�1! e e� .-44-G Maximum live load to be borne by each floor I hereby sub t all the plans and specifications fors 'd building. All notices be sent to C,1��I57l- __.. (45 • - - - -__ The undersigned applicant for this building permit does he -b of labor under the Florida Workmen's Compensation Act, bein and has complied with the provisions thereof, and will require in the work to be performed under this permit; and will post or c or notices as are required by the Act. The undersigned agrees to e permit, as are licensed by Miami Shores Village. Remarks t ( S igned ) __ 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, be of the above therein by hi Permit No.__. Disap (Sig g by me describe state Building Inspector y sworn, u on oath deposes and says that he ion, carefully read the fore oin (5 PLANNING BOARD_ Chairman Member Member Council Approved Date with reference to the building and its construction may, y certify that he understands and accepts his obligations as an employer eneral Laws of Florida, Permanent Supplement, sub -contra srs employed by him ite of the w : rk such . , otice rk to b : erform nder : is is pplication, and that he did sign the same, and that all facts Read, Sworn to and Subscribed before me. Nottiry Public, State of Florida My Commission Expifes DATE Member , Member Member 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 ipspection or faulty materials and /or workmanship. ^ : z • (1) \iv(' y / / I 1 4 5 CI 'r OP) k °11 (f