ROOFINGBUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement ur ine 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 nil 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.
Joan M. Habersin
Owner's Name and Address ...:....._
be sent
peared
Chairman
Member
Member .. ... _ . - ...._..._.._.
Council Approved Date
NOTE: A charge of 31.00 will be made for
the PLinnir.. Board.
A r•insprction fee of $1.00 will be charged
materials anti /or workmanship.
MIAMI SHORES VILLAGE W7C-
Date..._.. Februarl 20.... _ _......_._._..._.... ,19..
51 N.E. 9th St
No »....__....... trees._._
Registered Architect and /or Engineer ..:.. , <, ••,,,,,;,,,,,,,,,,,,,,• ..,:...
Name and address of licensed contractor...F.1l7.dr..ek/S. AQ ...... .. CA... 43AD... E.....n.th..Aue11UP.,...Hiral.e h,...F1_......__
Location and legal description of lot to be built on: s p
Lot.f
4- 19/7 1 i. ./..1 Block Subdivision!. /.F ,� !.?�.�1.i'..�.... -.-.� +aQ -al» ,�.� .. � Pl B- .....
Street and Number where work is to be done 51 NE 99th Street, Miami Shores
State work to be done and purpose of building (by floors)..... L — EOOF HOUSE COQ"IPl Y.aS
Tile. #30 uncapped x#15 asbestos mopped, #90 slate mopped...TILE
Roof Covering CJAY TILE
Notary Public, State of Florida
Building Inspector My Commiuion Expires
PLANNING BOARD DATE
.r.__ _._..._.:......and for no other purpose.
New Building Remodeling Addition Repairs RE ROOF No. of Stories
To be constructed of Kind of foundation
Estimated Total cost of improvements s.....7.41).0...0.0 Amount of Permit 3...30.00...
Zone cubage required Plan Cubage
Distance.to next nearest building Size of Building Lot
liaxirnum 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
Charles K. Andrews
to......�1OhI1..C.... Pax> slrPtnis.. n�l� !elozs..RoQfi,...fi..Tmp...Co
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor 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 om all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be po or inspj Lion on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only , ubco actors, wor rformed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks (Signe
- ../c 4/ a�ay29
STATE OF FLORIDA, 1 .
COUNTY OF DADE. i ss'
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally op-
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
Permit No .,2 iiig 6
therein by him stated are we. � ��
Date Read, Sworn to and Subscribed before me.
Disapproved ....r ... .: r ... Date
(Signed)
Member
Member
Member
Disapproved Date
making corrections or changes to this application after approval has been obtained Imin
when such re- inspection is made necessary by Improper notice for inspection or faulty
APPLICATION
Application is hereby made for the approval of the plans and
specifications herewith submitted for the building or other
sturcture herein described. This application is made in com-
pliance and conformation with the Building Ordinance of the
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 Department of
Miami Shores Village, shall be complied with, whether specified
or not.
T Ktir / �7 ,
OWNER r l g ' i,,: -•' ,;• , f�,A® -tR -e
s
y -....
T " , 0 �s ; >'4 `�;` , CONTRACTOR,,, y ?
ARCHTTEC t .„4.4 ;e1A.C.,0 -)
/ p ' LOT J ? ISION - �;3e g il i
NEW4ADDITION REPAIRS NUMBER OF STORIES
--- ,� ROOF ,,d
COST (excluding Archtitect's fee, landscaping & garage )$$ tftr -'
Building to be used for �^
s� and no other use.
I hereby submit a;ll the plans and specifications for said building.
Signed '�� ° . %a:� � � ,A��..:•��p
, r
t �
Before me, the undersigned authority, a notary public, duly
authorized to administer oaths and take acknowledgment, personally
appeared to me well known, and
who, being by me first duly sworn, upon oath deposes and says that
he is the builder of the above described construction, that he
has read the foregoing application, and that he did sign the same,
and that facts stated by him are true. Read, Sworn and Subscribed
before me,
STATE OF FLORIDA)
COUNTY OF DADE )
My Commission expires
Cubic Feet k7O4o Cubic feet required in this Block jfer7 0 , 1
Chair
Secretary ,
Building Inspector
Permit No. � = Issued t
Electrical Permit No.
BUILD'TNG - PERMIT RECORD
MIAMI SHORES VILLAGE
FLORIDA
Notary Public(Signed)
PLANNING BOARD
41111
/ 2A2.
-�� 1, Date J d
rlu_;ibing Permit No.
DATE
�9)
•