25 NE 99 St (12)if fif .
J
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.
Owner's Name and Address._ %Fie
No Street
Registered Architect and /or Enginee ....
Name and address of licensed contractor..
Location and legal description of lot to be built on:
Lot �-� Block 5 Subdivision
Street and Number where work is to be done._._, ..... _. -,. T9' ` .ri
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building 2 Remodeling Addition Repairs No. o tqr• /
Estimated Total cost of improvements $
Kind of founda �t Roof Covering
.mount of Permit $ e
To be constructed of
plan Cubage__.._t�_ 2-0.577 /
Distance to next nearest building.___. Size of Building Lot .. . j
Maximum live load to be borne by each floor
I hereby s • it all pan and : • _'. ' / oris said building. All notices with reference to the building and its construction may
be sent to.. -: r 1 '' 1 /D tc /t..' e" / " 4 if /i`, `a3
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 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 woric.such ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such s /contractors, on work to • or • under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed).. L,N� : �� _ - • 1� /
Zone cubage required .__. / .Q
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
MIAMI SHORES VILLAGE
Date
6 1 `
Z
STATE OF FLORIDA,
COUNTY OF DADE. j 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 carefully read the foregoing application, and that he did sign the same, and that all fasts
therein by him stated are true.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
Building 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.
ikk c"
¢osi
y
d
■
1
x
�
r
.5
AI .1
r
•
5
5
CO itj\
r
cRbER NNO. /5547
F. B.
J. B. FORD CO.
1774 W. Miller Street
MIAMI 3& FLORIDA
Telephones: 9-3608 82 -0027
If
1
b N
t
v
D. Hole
57
22
"/err 5T
I!
to the beet of my.
Thos ass no •
5Jlc
'Z
s' *yea a moe
,v
ra/eiJ /,mil
/5 , e/ity r
Dot -- ?rx///i- 12, /°6G,
ORS 427
DA
cue'
Xbter in o4'
%ire/ co/ Ioffi.9,ear
Ave ?kir Atom/ .,vlt39ES 54
According to the Plat thereof as recorded in Plat Book /o , at Paqe70 .
Public Records of Dade County, Florida.
Fts# rj,=,Co Pie S..
,1 11■.
al?_-k - 3-o x r40
x 13
11 -
1( - x_ 1- 6
,L
4 :
I e
- 4- -1 42- 7
'
•
il.A‘t4
- if:Achk n1 =if i+4 =
i j 21—
•