MECHANICALMIAMI SHORES VILLAGE, FLORIDA
DATE
ELECTRICAL
PLUMBING PERMIT N9 6921
❑
BUILDING ❑
ROI & c
Owner of
Building r
Architect
Contractor 1
or Builder
Legal
Description
Lot
r ;.. -..
Work to be performed under this Permi
B1
CONTRACTOR OR BUILDER
Contractor's
License No.
BY AUTHORITY
!o -ate 1-
Subdi-
vision
Address of N / L Value of c Amount of � �
Building a – , �+ Project $ t v� < r "" Permit $ —�
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 applica-
tion 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 or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
r1
Signed INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in comp ce with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as
cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee.
1
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR UILDING 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... 11A/� / .7t . _.._ -.. ____ �...... ,19.8.6
Owner ''
Owner's Name and Address " ' 1 1 i�z4' .» No 2 `X 9 Street._6L _ • 2..e 5TEE - GT
Registered Architect and /or lyngiricer..... - QJ19
Name and address of licensed contactor.. - ► '&Y.fkL ..4l.L C0hlPlTi0RIm�i..a.Ldic
Location and legal description of lot to be built on: y/�/ Q �/ p
Lot-. c' i . /.. 7.-- - - - -.- Block c ,, Subdivision - - !,c . t-- - - fier .Li1 J; ._ —._11 - � ? 4
Street and Number where work is to be done. - 49 9a3rREDT-._
n
State work to be done and purpose of building (by floors)-.Rt'.aq . -- !-5 l- -i1. - Ql vall." -- ,_..l tl;?►�I F. ct<
- rtt).F1O t ►M IT k4 A. MEW_ "Zhr.l.fhe..u.11. 3- i v■i Axe.Casli TIOL lrlh
L,
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation . Roo Covering
Estimated Total cost of improvements $ a ( 50 OQ 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.
be sent to..
The undersigned applicant for this building permit does hereby certify that he understan
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled C
and has complied with the provisions thereof, and will require similar compliance from
in the work to be performed under this permit; and will post or cause to be posted fo
or notices as arc required by the Act. The undersigned agrees to employ only such
permit, as are licensed by Miami Shores Village.
Remarks ( Signed ).A.
6 5
All notices with reference t• building and its construction may
s and accepts his obligations as an employer
al Laws of Florida, Permanent Supplement,
s or s • -con tors employed by him
the s oft ork such ublic notice
on 'rk to f performed under this
6
C.J 3
• • • s - -- sass
STATE OF FLORIDA, k
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, 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 e. -�
Permit No. -___ 1 d( Date -.•- 0.1S1 Read, Sworn to and Subscribed before me,
Disapproved \ - -... Date
(Signed)
Building Inspector
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member sass.. — - _..._._ sass_.. .. 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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Subdivision
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E5-r ST. TERR., AVE., CT., PL.
Legal: Lot No. Block No.
t1 . 4cc► fvnO
249 I . 96 ova
NOTE: 1. Show estisting buildings and additions.
2. Show distance from property 'ines to buildings and/o7 new additions.
NORTH ARROW
0 I,",1]Th i'\'.3 C''Ar:'::11c4ED 0 1;;;,,T:A VA7,I.A2S'
A7;C'IS nolo TEE f'.1A:"Il ,V9S i:LI:I.L;:'N'illi".3ZCNIM
0,1171I'MCL'ESI;;KCE FERMITrED, E ,C."-=;:c.:1:: . I.. OELOW.
Ali C7iM k?arlYCLE STATE A'D CC:3;,ITY S7 '13:1 CIX.
MTh BY A:L1 PATii.S.
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CO1T-LP..ANIU ',",/ffir: IliZ SO:I FOXI:DA S'tiii.01 G CODE AS ADOPTED
By Ef..::) SKZ:7.28).1:LtA". is REC.P.ED. T: 'E AP.CHITECT, BUILDER &
St a cr.1,imacTans. AIX "'"'" - OF ALL BUILD-
ONG REGULA7S VITYLFV:7] En fif3 S: [C,',D:CATED HERM.
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COI
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 _ 0 o , f' , 19 ('" '
Owner's Name and Address /!4 k1 G A H 4 No.t Street N' r6', Y ''' S
Registered Architect and /or Engineer •
Name and address of licensed contractor r c, l'6' (?) h '` gI N 0 11
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done _ •? ® i " - ... . " _
State work to be done and purpose of building (by floors)
MIAMI SHORES VILLAGE
xrrro
cart
N '
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
�c� .
Estimated Total cost of improvements $ / Amount of Permit $
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot
roar
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, 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 inspe ion on the site he work ch public notice
or notices as are required by the Act. The undersigned agrees to employ only such sulfco actors, on wpr by pe ormed under this
permit, as are licensed by Miami Shores Village.
Remarks.-__...__._____._____ (Signed)
STATE OF FLORIDA, I
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, 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 (C q a ! Date -10 — 2.'2.. -G ( Read, Sworn to and Subscribed before me.
Disapproved .._ Date
( Signed) n `ct ,— � Notary Public, State of Florida
.. / �"l o `� – _"`
Building Inspector My My Commission Expires
PLANNING BOARD DATE
Chairman .__ Member
Member _____.___.____.._ Member
Member Member
Council Approved.__._ Date Disapproved Date
NOTE: A charge of $L00 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 ,31.00 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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