WINDOWSMIAMI 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 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 the work.
Owner's Name and Address
STATE OF FLORIDA
COUNTY OF DADE.
} SS.
Registered Architect and /or Engineer AJ<I1u P
Name and address of licensed contractor r-/CW e
Date J 2 C 19
No. 3 / 0 Street A) es 9 2,s-
Location and legal description of lot to be built on: /1' 3 a � ae
Lot 7 0 Block 4/ / Subdivision 4-777-
Street and Number where work is to be done ?fi(3 �f � • 99
State work to / be done and purpose of building (by floors), exterior rs mit samples) l. Oirl� 4 7 e:C1l �/r%r ;
/./U5'/.9- / /�jo,.v .9 s / / ` 0,+1 ' - z- 8 per- ;7 ,#` 2�'7,�®
�I9 7DZ ) ee� p/U "7" - / /'- (3' t and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation yf�'O�� Roof Covering
Estimated Total cost of improvements S Amount of Permit S
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 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 obligatons 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 caus 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 . mploy only suc. s . , on,•.rk to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Sign
- arm/ /i /_
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 f.regoing application. and that he did sign the same. and that all facts therein by him stated are true.
1 + 1
Date -1'
Permit No.
Disapproved 1 � `� \A Date
(Signed)
Building Inspector
Read. Sworn to and Subscribed before me.
PLANNING BOARD DATE
Notary Public. State of Florida
My Commission Expires
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of S25.00 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 525.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.
Application is hereby mode for the approval of the detailed statcusrne us toe plans and specifications herewith submitted for the build
inc or other structure herein described. This application 1s made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and all provisions of thc Laws of the State of Florida, all ordinances of Miami Shores Village and *II 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 prggreu of the work.
Owner's Name and Address
Registered Architect and /or Engineer ..............
�.?t:7z4.t�
Name and address of licensed contractor siAVN._?.-
Location and lc al description of lot to be bu'lt on:
Block Subdivision.. .1..h // _ '° /� Id r 0
Street and Number where work is to be done ca,..0 .../ _qg _..._._.. __
State work to be done and purpose of buildiinng (by floors)..-X44 —pia 2.I9k
_.. ?,cerIQr a{ aus.e,
Lot / 7#
Ncw Bui!ding Remodeling Addition
To be constructed of Kind of foundation Roof Covering
Estimate Total cost of improvements S VOO
Amount of Permit S.
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 Libor under thc Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup lenient,
anti has complied .cith 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 subs ntractors on work to be performed under this
pennit, as are licensed by Miami Shores Village.
Reinuks..._ (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
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 . true..
No.._'. ..L.!�v Date qQ Read, Sworn to and Subscribed before me.
Disapproved r Date.
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
we. eada
<Zee /4 e •
epairs y�
14,
Notary Public, State of Florida
Building Inspector My Commission Expires
L .
7,1 7-- 7 7
. Street e DA
and for no
No of Stories
O
other purpose.
V
to me well known,
PLANNING BOARD DATE
Chairman Mcmbcr
Member Member
Mcmbcr .. .. _.....__....._..._._...._....._ Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application niter approval has been obtained faun
the Planning Board.
A rc•iri.pc•c•tion fee of 51.00 will be charged when such re - inspection is made necessary by Improper notice for inspection oe faulty
materials and /or workmanship.
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2. ADDRESS
LEGAL DESC.
MIAMI SHORES HISTORIC PRESERVAT:TONBOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
1. NAME OF PROPERTY: c1 /ocicct r 1)04/e% A2U 44,J
3. NAME OF OWNER & ADDRESS:
3/0 t/6 99 $
4. NAME OF APPLICANT & RELATIONSHIP TO OWNER: ( /� Udirl AAA
5. PRESENT USE AND CONDITION:
6. TYPE OF PROJECT: (circle one or add unlisted project- (J. OTHER)
A. MAINTENANCE OR REPAIR
B. RESTORATION
C. REHABILITATION
D. ALTERATION
E. ADDITION
F. EXCAVATION
G. DEMOLITION
H. NEW CONSTRUCTION
I. RELOCATION
J. OTHER (EXPLAIN) Winfbc .)S
7. IS A ZONING VARIANCE REQUIRED FOR THIS PROJECT? r
A
8. DESCRIPTION OF PROPOSED PROJECT, INCLUDIi'.G'WHAT CHANGES WILL BE MADE
AND HOW THEY WILL BE ACCOMPLISHED.
_4/C2c1 , , , i . r09 / /Di _ & Wdo61)S 60 6, qor iiti
w &t ii;JdorAls . z� bod/ /� chacyt, rpara�(P,
4om. -{1,. kILt I ANS C . 7 r.✓.mixyJ.
rp
4,edl (c - -- (46. 606-)
9. IF USE OF THE PROPERTY [JILL CHANGE AS A RESULT OF THE PROP..OSED.WORK,
EXPLAIN THE IMPACT OF THE CHANGE. 27 40// a /64.) or into
Du` 71 ;9/) roonv� r �e,, /ten 614// / <. ad /� 1a
c� iju..
71e h,44 �rctoi , 64,0 illy (,✓J?d JS are 9w?,
The Board shall be supplied with copies of the Original Designation Report
filed when the property was designated as a Historic Landmark and copies of
any Certificates of Appropriateness granted previously for this site.
771
DATE: S/3 //0
APPPouvn
hi.:071;;.}