146 NE 98 St (5)i
MIAMI SHD VILLAGE
BUILDING INSPEC O 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.
Owner's Name and Address No. Street
Registered Architect and /or Engineer
Name and address of licensed contractor
Location / and legal description of lot to be built on:
Lot a E. ` ?Block / Subdivision 5
be sent to '
V
Date , 19
Street and Number where work is to be done
State work to be done and purpose of building (by floors) -:.
'2_
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering r
Estimated Total cost of improvements $ 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
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 work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontraeps, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) !
1
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
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 Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
to me well known,
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.
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BUILDING ❑
ELECTRICAL ❑
PLUMBING ❑
ROOFINp n ❑
f L') ' ' /1 L'Sl
Owner of
Building
Architect
Contractor
or Builder -'f �< / ( �!��� �. le:Cr/-
Legal Lot
Description � B1
Address of / /
Building
CONTRACT
MIAMI SHORES VILLAGE. FLORIDA
DATE - 195
OR BUILDER
PERMIT N° 6771
Signed.
Contractor's
License No.
Work to be performed under this Permit r ' 1 'K. r ;r�
r Z. -C
Subdi-
vision
Value of ;
,-,I11 Amount
Project $ ) 7 ( ! Fermit
of (2-6
This permit is granted to the contractor or builder 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 ordinances 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 named 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 cr in the statemeyts.or specifications and thc t he assumes responsibility for work
done by his agents, servants or employees. "<".._
BY
In consideration of the iss a to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict co rmity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume re onsibflity for all work dojapArreither, myself, my agent, servant or employee.
BY AUTHORITY
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 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 C ;"` 2 , 19
Owner's Name and Address.. /44 . C? :.._ - `l.4.
t� No.../`,' Street. 14 i :- .-44 .....;
Registered Architect and /or Engineer...- . -- .-- - -,
Name and address of licensed contractor -- _ __.. - �' - .:.
Location and legal description of lot to be built on: ` t"e..v
Lot Block Subdivision
Street and Number where work is to be done i 4; 4/.4: 18 � ?-;
State work to be done and purpose of building (by floors) ..1 '41 . 1.--- - , 3 7 � LL 1 /.,cater' c f"' -e . - .GC44zadAnt. C!2
6 "cn_ ev)-f z.zc- ,ca_e4e.5- -(C re 5)-- .r1.✓ -o -. it .ele.:Z:At /7' 4 " . " - A2_7 - 1A/1 - 1 - 1
. 4i. - 4 - 4Cl-K. _A..d.A.'.`..� and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
r t -0 c,..... Estimated Total cost of improvements $ 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 mit all the ns d specifications for said building. All notices with reference to the building � and its construction may
be sent to..,. C ;I.�t.=.' -.r.. M.A.4.�I.�•t�-?,1 - - p 1 3 f' 2 41.14/% 4e - - /f - il! FGA -A -.,
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 em loyed by him
in the work to be performed under this permit; and will post or cause to be posted for in tion on the site o work s h public notice
or notices as are required by the Act. The undersigned agrees to employ only such su ontr ctprs, on wo rmed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed).
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 facts
therein by him stated are true.
Permit No 4 "- 7_
Disapproved D
(Signed) ..
Building Inspector - . My Commission Expires
t ^
Date '� 2 ' ? 1_. Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
PLANNING BOARD DATE
Chainnan 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 -i spection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.