FENCEBUNG 0
ELECTRICAL 0
PLYING 0
ROOFING s 0
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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.
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