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PLUMBINGOwner's Name and Address Size Septic Tank Feet of Drain Tii le____a" Nature of Water Supply: City -Well STATE OF FLORIDA, es. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No —_-- Date Registered Architect and /or Engin r - - - Employing Plumber's Name _/ Location and Legal Description Lot.______ — _____. _ __� Bl Street and Number where work is to be performed -No Amount of Permit $ v ..... - — (Signed)___ - - Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitt d for the building 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 work. No. - 2- S Street ��� .. Street. r� (Signed) Street State work to be performed and purpose of building (By Floors ) _ __.___ New Building.. Remodeling_ - _______ Addition_______ Repairs No. of Stories Capacity Gals ... or Drain Field from Well Size of Soakage Pit lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli:..ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin: "t Supplement, and bus com- plied 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 are required by die Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 hira stated are true. My Commission Expires Notary Public, State of Florida /D Master Plumber. NOTE: A :re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS TUBS TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•N8 TOTAL FIXTURES CONTR. LIST CHECK __ SEPTIC TANK SEWER CONK. DRAIN FIELD SOAKAOE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL 1.___— CONTR. LIST __ CHECK Owner's Name and Address Size Septic Tank Feet of Drain Tii le____a" Nature of Water Supply: City -Well STATE OF FLORIDA, es. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No —_-- Date Registered Architect and /or Engin r - - - Employing Plumber's Name _/ Location and Legal Description Lot.______ — _____. _ __� Bl Street and Number where work is to be performed -No Amount of Permit $ v ..... - — (Signed)___ - - Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitt d for the building 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 work. No. - 2- S Street ��� .. Street. r� (Signed) Street State work to be performed and purpose of building (By Floors ) _ __.___ New Building.. Remodeling_ - _______ Addition_______ Repairs No. of Stories Capacity Gals ... or Drain Field from Well Size of Soakage Pit lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli:..ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin: "t Supplement, and bus com- plied 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 are required by die Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 hira stated are true. My Commission Expires Notary Public, State of Florida /D Master Plumber. NOTE: A :re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder Legal Description. Address of Building Lot Work to be performed under this Permit Owner of —74 Building f ,..fi' 1 , .► e Sic CONTRACTOR OR BUILDER MIAMI SI-IORES VILLAGE, FLORIDA PERMIT N° 9756 t Bl. Subdi- vision Value of Project $ BY DAT Conttactor s ,` License Noa, ,. C..x.. s:- c.. \ This permit is granted to the contractor or bulilder named above to construct the building or to install the equipment or device described in the application 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 approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinanats or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder mmned above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the, plans or drawings or in the statements specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • 1 �� y , /� I " } 1 M ,+�;. , f ... By ' ./. ., INSPECTOR In consideration of the issuance to me of this permit 1 I agree to perfori the work covered hereunder in compliance ,with all, atc dances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submittdd to the proper .thoritfes of , Miami Shores Village. In accepting this permit I assume responsibility for all work ,done by either, myself, my agent, servant, or employee. . 1 /, Amt. of Permit $ AUT HORITY 195 Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subrni structure herein described. This application is made in compliance and conformity with the Building Ordinance of M 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 work. Owner's Name and Address . _ . Imo C_15 14 No Street Registered Architect and /or En in r C !2!G4 _ , m k Employing Plumber's Nae____ 444,4 (0. No _ 7 / C� sweet__5 / < 1 . Location and Legal Description Lot / C. Wi Block / Subdivision t' +'r Str-a 4..4 Street and Number where work is to be performed- No. __ 1_2 r Spa /1v , - Street 1 9 State work to be performed �a~nd purpose of building (By Floors) New Building L Remodeling Addition Repairs No. of Stories Size Septic Tank • Nature of Water Supply: City -Well � s Amount of Permit $. /2't ATE OF FLORIDA, UNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date Type of Tank____ Capacity Gals Feet of Drain Tile_______ Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit ,_, ( Signed)._ The undersigned applicant for this building permit does hereby certify that he urrdei.stands and accepts his obligation as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has corn- plied 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 are required by the Act. The undersigned agrees to employ only such sub - contractors, on . ` i rk to be performed under this permit, as are icensed by Miami Shores Village. m. l for th building or other i Shores Village, Florida, Iumbing Inspector. (Signed Master Plurnber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared well known, and who, being by me first duly sworn, upon oath deposes and says that he is the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts by him stated are true. My Commission Expires Notary Public, State of Florida E: A re- inspection fee of $1:00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty nd/ or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT :NS M TOTAL FIXTURES CONTR. LIST 1 / / CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL I 1A4 .4 0 1 CONTR. LIST CHECK Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subrni structure herein described. This application is made in compliance and conformity with the Building Ordinance of M 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 work. Owner's Name and Address . _ . Imo C_15 14 No Street Registered Architect and /or En in r C !2!G4 _ , m k Employing Plumber's Nae____ 444,4 (0. No _ 7 / C� sweet__5 / < 1 . Location and Legal Description Lot / C. Wi Block / Subdivision t' +'r Str-a 4..4 Street and Number where work is to be performed- No. __ 1_2 r Spa /1v , - Street 1 9 State work to be performed �a~nd purpose of building (By Floors) New Building L Remodeling Addition Repairs No. of Stories Size Septic Tank • Nature of Water Supply: City -Well � s Amount of Permit $. /2't ATE OF FLORIDA, UNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date Type of Tank____ Capacity Gals Feet of Drain Tile_______ Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit ,_, ( Signed)._ The undersigned applicant for this building permit does hereby certify that he urrdei.stands and accepts his obligation as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has corn- plied 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 are required by the Act. The undersigned agrees to employ only such sub - contractors, on . ` i rk to be performed under this permit, as are icensed by Miami Shores Village. m. l for th building or other i Shores Village, Florida, Iumbing Inspector. (Signed Master Plurnber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared well known, and who, being by me first duly sworn, upon oath deposes and says that he is the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts by him stated are true. My Commission Expires Notary Public, State of Florida E: A re- inspection fee of $1:00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty nd/ or workmanship. / 7 Permit No z Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work. Owner's Name and Address ___J...; , !. No Street Registered Architect and /or Engineer , o Employing Plumber's Name n Location and Legal Description Lot 1 Block Street and Number where work is to be performed—No I ` -� Size Septic Tank Feet of Drain Tile Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. 1 SS. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ,_ No. Street t (Signed) ( Signed) Street A Subdivision__ u. c' p d t e t i My Commission Expires Notary Public, State of Florida , �, State work to be performed and purpose of building l By Floors) i New Building Remodeling Addition Repairs No. of Stories____. Type of Tank Capacity Gals Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit lumbing Inspector. The undersigned applicant for this building permit 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 com- plied 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 are required by the Act. The undersigned agrees to employ. only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA - TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK — SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. . LIST CHECK Permit No z Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work. Owner's Name and Address ___J...; , !. No Street Registered Architect and /or Engineer , o Employing Plumber's Name n Location and Legal Description Lot 1 Block Street and Number where work is to be performed—No I ` -� Size Septic Tank Feet of Drain Tile Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. 1 SS. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ,_ No. Street t (Signed) ( Signed) Street A Subdivision__ u. c' p d t e t i My Commission Expires Notary Public, State of Florida , �, State work to be performed and purpose of building l By Floors) i New Building Remodeling Addition Repairs No. of Stories____. Type of Tank Capacity Gals Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit lumbing Inspector. The undersigned applicant for this building permit 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 com- plied 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 are required by the Act. The undersigned agrees to employ. only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. c Permit N --Y'� Date_: ..! `1___I_ '' a Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 wor Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Z'ot_ Street and Number where work is to be performed -No STATE OF FLORIDA, COUNTY OF DADE. State work to be performed and purpose of buildiqg y New Building __ -- _ -- Remodeling Amount of Permit $.__ ._ ..... CI MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. Street__ Blorti a 5 s Street. Addition________ ________._ Repairs___ No. of Stories Size Septic Tank ___________Type of Tank Feet of Drain . __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City - Well.____ — __ _ _____Size of Soakage Pit • (Signed)- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig . tons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennant, t Supplement, and has com- plied 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 are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to bed performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection ie made•necessary by improper notice for inspection, or faulty materials and /or workmanship. Stree T .. Subdivision _ -_ -- C AR . Capacity Gals Master CLOSETS BATH TUBE W SHOWERS LAVA. TORIES INK SS SLOP SINKS LAUNDRY Tues U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREAIIE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G PO L CONTR. LIST - -.- CHECK c Permit N --Y'� Date_: ..! `1___I_ '' a Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 wor Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Z'ot_ Street and Number where work is to be performed -No STATE OF FLORIDA, COUNTY OF DADE. State work to be performed and purpose of buildiqg y New Building __ -- _ -- Remodeling Amount of Permit $.__ ._ ..... CI MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. Street__ Blorti a 5 s Street. Addition________ ________._ Repairs___ No. of Stories Size Septic Tank ___________Type of Tank Feet of Drain . __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City - Well.____ — __ _ _____Size of Soakage Pit • (Signed)- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig . tons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennant, t Supplement, and has com- plied 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 are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to bed performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection ie made•necessary by improper notice for inspection, or faulty materials and /or workmanship. Stree T .. Subdivision _ -_ -- C AR . Capacity Gals Master 0331 MIIAMI 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. p , Date_ Owner's Name and Address r..__ ._.ii`tlY 5 !! T ∎A) t V No i 2 5 Street L�lry 4 Re Architect and /or Engineer.. C- Name and address of licensed contractor_ 14.4 C' r'.t_ Q J°.ld!► Q R e,�_� �n _C 0 k _W ,- 14.011.olvn g 6.1e, Location and legal description of lot to be built on: Lot.! 3 4 - -- Block 1 Subdivision___ Street and Number where work is to be done__.( 5 Z U.E a __ q9 T N s -- r. State work to be done and purpose of building (by floors) i X_3 0 L G_41,2. 4 -7 e__ _tal LIM.IxI _l .._ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind '. of foundation Roof Covering Estimated Total cost of improvements $ Zone cubage required Amount of Permit $ 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 11:e- r 2 5 5 (le ! '� / The undersigned applicant for this building permit 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, Pennanent 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 th work s ch ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to per mec under this permit, as are licensed by Miami Shores Village. Remarks ( Signed ))1( STATE OF FLORIDA, COUNTY OF DADE. j Before me, the undersign d authority, a notaryyublic, du authorized t administer oaths and take acknowledgments, personally ap- peared - �I GC.I AgVi . '7 / 13 S O /V SS. 4 Permit No._______ _ Date 3- 2 3 and who, being by me first duly sworn, upon oath deposes and says that he is the of the above describ d co struction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him Building Inspector 7 Disapprove Date (Signed) PLAN: Chairman Member Member Council Approved Date 25 ' 2 Notary Public, State 'Of 'lorida TN to me well known, ommission Expires 1'SO; - PUBLM, T,.1IE_GLFL9R.Jf? &r7; N1V cc aa7"_ ci.re, � 1 :° �:;L nu o, 30, 1974 BOARD DATE BONDED THROUGH r1...•.D iy. Dlt3 ELti:iRSI 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 inspection or faulty materials and /or workmanship. STATE OF FLORIDA, ss COUNTY OF DADE. Before me, the undersigned auth peared 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 and specifications the Buildingu Division t b i during M Shores hal b tco work. with, whether herein specified or not. A copy of approved No. A. 125 Owner's A s Name and Address.__ _r__ j'._ --n - -L' -- ,-_} .. Iy_ ti.�._i__ / Registered Architect and /or Engineer G �' `/ p (7___h r td? _O__ /lam > Name and address of licensed contractor_ f i 5 -- e__ --Q- e ./ Location aid legal description of lot to be built on: Lot %3y _ .4 . 4 - - -- Block / Subdivision Street and Number where work is to be done C e .� A./E /,Y 3 0 '‘,/1.1; State wo to be one and purpose of building (by floors) I GC.M-M PLANNING BOARD Read, Date____ 5 - 2 5 p-/-/011 Lt_QY e Amount of Permit $ plan Cubage Size of Building Lot , o 9'X /t2 d Subscribed- before ,19 7 2 Street fr 9 9 r 'Ai./ v Yfrl / 145 and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Zone cubage required Distance to next nearest building 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 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 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 are required by the Act. The undersigned agrees to employ only such subcontractors, on work performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed )) ity, a notary public, duly aychorized to a dminister oaths and take acknowledgments, personally ap- 6 ' (�1t_3S 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 Date Disapproved Date (Signed) Notary Public, State of Fl n a Building Inspector My CommissiontEartf✓ l.YC„ STRED7 frP llitan -b C� g I P ector @JV P.°O?c7P:llOSi: N Alia 39. 1974: 801f E 7HROUGH FRED W. 0IESTEc Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be tirade 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.