BUILDING (4)MIAMI SHORES VILLAG
BUILDING INSPECTION DEPARTMENT '
APPLICATION FOR BUILDING PERMIT
?, 7.. 775
Application is hereby mode for the approval of the detailed statc:: are me plans and specifications herewith submitted for the build
inc 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
Owls and specifications must be kept at building during progress of the work.
Date..._.._. �.._.Z- _�......__... ,19.P.b.
Owner's Name and Address ...A.4/./
..A /. 5° /.1..A -7 ..:: —. _ ._ No. :SA, _ Street.. :_ 7 _/
Registered Architect and /or Engineer _,/)� I
Name and address of licensed contractor Gfl ? e:� !'V./ `'
Location and legal description of lot to be bui on.
(Signed)
Disapproved ... Date..
Building Inspect
221
Chairman
Member
Member. .. _ ....._......_..._._ ...._.....
Council Approved Date
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials anti /or workmanship.
My
... ,., 1f VIVITTIVIV .. 1 .. *I ..... 'MI.
Lot — 7d e....... Block Subdivision y :..•�•• lartl.L.... c
Street and Number where work is to be done Zia 42 61 9 _.._ --
State work to be done and gurposc of building (by 9oors ) ?e.. / Pe+.''t/2.e.Air KJJ}
A) G. fewse ,�� '7 7 ?9//c
Fitt ardeo' Q 'i° . .5' and for no other purpose.
New Building Q Remodeling Addition Repairs No. of Stories
To be constructed of .0 Kind of foundation /D..., Roof Covering
Estimated Total cost of improvements $•.•. ee - Amount of Permit & .7r.. tY
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 specific/aaat�ttiio''ns o said building. All notices with reference to the building and its construction may
be sent to.. ..Q. der
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 tl:c 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 noticcs as arc required by the Act. The undersigned agrees to employ only such su r; actors, rk to . rfo ed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks (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.. _ /
Permit No.._ -._.° lL�.� Date`s //y! 64 Read, Sworn to and Subscribed before me.
PLANNING BOARD
orts 11AP 1/ 3.a?l16._.j 5 5 5 5% 6
Notary Public, State of Florida
Commission Expires _.
to me well known,
DATE
Member
Member
Member
Disapproved Date
making corrections or changes to this application after approval has been obtained fans
when such re- inspection is made necessary by improper notice for inspection or faulty
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17. —
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May 13, 1986
aiami cbores91llage
F L OR ID A
The members of the Historic Preservation Board and I
approve of the Aulton's proposed alteration to the existing
wall on the alley. We understand that they will construct
a new wall to match the remaining existing wall.
Margo newton
Chairman, Historic Preservation Board