Window and door replacement.•
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 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.
754 -2577
Owner's Name and Address JACQUELINE PORTAL = = == 45 N_E. 98 STR PET , ¢T SHORES-, FTWRIDA.
Registered Architect and/or Engineer
SEYMOUR GOTHELF.
Name and address of licensed contractor
Location
T ionn and legal description of lot to be built n
Lot C... k A/ / /7Block Subdivision `//
2 l O, 1! 52 /0 //YF q
SECURITY WINDOWS.
•
Street and Number where work is to be done
State work to be done and purpose of building (by floors). state exterior colors (submit samples) REPLACING 2 JAL WDWS AND 1 P/W
AND 1 WOOD DOOR WITH 2 ATW, t P/W AND 1 ALUM DOOR IN EXISTING OPENINGS. NO STRUCTURAL CHANGES
COST $ 1705.00
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements S Amount of Permit $ n? 0( 55
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 L.. or under the Florida Workmen's
Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement. and has complied with the provisi 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 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 agre4 . employ only suc.• on work to be performed
under this permit. as are licensed by Miami Shores Village.
Remarks (Signed).
STATE OF FLORIDA J
COUNTY OF DADE. ss.
Before me. the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared
Ste- G , i+ w-w
and who. being by me first duly sworn, upon oath deposes and says that he is the C1" twfL
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 h;m stated are true.
Permit No. e9Gbo --"
t
Date / °
Disapproved 1 , C Date
(Signed) } b '� 1 1� T d
Building Inspector
rte
Read, L•Y, orn to and Subscribed before me.
Date DECEMBER 11, 198919
Notary Public. State of Florida
NOTARY PUBLIC STATE CF FLORIDA
My Commission Expires NY COMMISSION EXP JULY t5 .I991
PLANNING BOARD DATE gONDED THRU GENERAL INS. Ms
and for no other purpose.
to me well known.
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.