1199 NE 99 St (3)Location and legal description of lot to be built on:
Street and Number w
State work to be done and purpose of build'
✓ir ,:sir• i �. Yt Kt �> '7 c�It a
MIAMI SHORES VILLAGE
Building Inspector
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement ur me 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
Owner's Name and Address ..0�.� .4!/1� cA ge€14xn4i. �.1 <�421"
Registered Architect and /or Engineer
Name and address of licensed contractor C:!.r.� <
"r�'inale- = {t'21— " Cx
Lot 1 Block ..... Subdivision
..
.,1.,,,111 ..... .....:..... -., _..
t�1
etiss n t-• v tt�y .�rt/ c. c�
hero work is to be done ..l /..:1....11i�.....y` . 2,EL
( by floors / F, % / j nib c &
n - ♦ II 27 �!
.. z_ <+. - - `�' 1t:4)• 4t.4L,' L rr.' 4-
Addition Repairs No. of Stories
A po( Covering
tp
New Building Remodeling
To be constructed of Kind of foundation
Estimate Total cost of improvements $ j ( L - 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 permit does hereby certify that he understands and accepts his obligations as an employer
of labor under t "Florida 'Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sopff)lement,
and has complied ss ith 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 sulacontractyrs, An work to be performed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks — _._._._ (Signed)
and for no other purpose.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Bcfore 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.
Permit No ... _�_ .).. 1_ Date.. 11 1 Q
Read, Sworn to and Subscribed before me.
Disapproved ....1.�.. Date
(Signed)
Notary Public, State of Florida
My Commission Expires
3//u
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 hecn obtained from
the PI inru,,;; Board.
A re m.pection ice of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
i10.1S'
SKETCH OF SURVEY
13o'
2 37•s
atrfc. n
CATION MAP
• 1 t, =1001
1, Block 178, of "REVISED PLAT OF TRACTS
79A, 179B, 179C, 180A, & N 1/2 180C, OF
3F MIAMI SHORES, SECTION 8", according to
t2of recorded in Plat Book 43 at Page 69 of
cords of Dade County, Florida, being
he Village of Miami Shores.
0 DATE: July 18, 1979
48, 49 SCALE: As shown
rIFY: that the attached SKETCH OF SURVEY
described property is true and correct to
ur knowledge and belief as recently sur-
tted under our direction.
. R. TOUSSAINT & ASSOCIATES INC.
LAND SURVEYORS
20 N.E. 126 Street, North Miami, Florida
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BUILDING
ELECTRICAL
PLUMBING
Owner o
Buildin
Architect
Contractor
or Builder
Legal
Description
MIAMI SHORES VILLAGE, FLORIDA
DATE 19
PERMIT N? 6488
ork to be perfor d under this Per
Lot
Address of / �,, ,,, Value a
Building Prefect
This permit is g nted to the contractor or btx' er ame above to construct the
cation herefor in strict compliance with all ordinances pertaining thereto and wit4 the and
plans, drawings, statements or specifications that may have been submitted to and approved
at any time if the work is not done in compliance with such ordinances or if the plans are
permit is granted is the understanding that the contractor or . builder named above assumes
regulations pertaining to the work covered hereby whether shown on the p
sibility for work done by his agents, servants or employees.
In consideration of the issuance to me of this permit I agree to ,r: :. the work covered hereunder in compliance wijp11 or
pertaining thereto and in strict conformity with the plans, dratvforig : atemeats or specifications submitted to the proper auilleities o
In acceStirlg this permit , If assume respo all work done b eithe myself, my agent, servant or employee.
CONTRA OR OII" BUILD ER
S�bdi-
BY
to
rx.
INv rCTOR
Contractor'
License No.
is
be performed is
al authorities. This
orization. A further
a thorough knowl
s or s . cification
AUTHORITY