ROOFINGApplication 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
Registered Architect andior ngineer
JAIME
Location and legal / ¢escri Lion of lot to be built on:
Lot a )4 / /l/ l Blocky/
New Building Remodeling
STATE OF FLORIDA
COUNTY OF DADE.
}SS.
MIAMI SHORES VILLAGE
• BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
3226 N w 30 St_ MIAMI,FL_
875 N.E. 99 St.
KOPETMAN 3226 N.W. 30 St.
State work to be done and purpose of building (by floors). state exterior colors (submit samples)
Addition
Date
2/11 19 91
No. Street_
Name and address of licensed contractor
✓ r // Jz46 5 /5
8/5
N Sdivipp
Street and Number where work is to be done
ROOFING (1- #30,1- #15,1 - #90 & TILE)
and for no other purpose.
Repairs No. of Stories
'lb be constructed of Kind of foundation Roof Covering PPROO
Estimated Total cost of improvements S 6000.00 Amount of Permit S 30� 4941-
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 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 s / h subcontr tors. on work to be performed
under this permit, as are licensed by Miami Shores Village. /
Remarks (Signed) / � fi I1� r / e■-�
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 foregoing application. and that he did sign the same. and that all facts therein by him stated are true.
Permit No. _ 3 4 1 g , -/ Date r // Read. Sworn to and Subscribed before me.
Disapproved l t Date
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Notary Public. State of Florida
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and:or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MIAMI SHORES VILLAGE. FLORIDA
❑ DATE r '- ' 4* 1951,0_
❑
PERMIT 11T° 3021 Contractor s / r. n
License No
Owner of / '
Building ea- 1iV C. 6,) i � 4.3
Architect
Contractor
or Builder ¢ ra � , s w r - 0
Legal Lot l
Description Bl
Address of ,,� ... e - h e
Building 8 "7 s f
Work to be performed under this Permit
4
Subdi-
vision
Value of
Project $
Amount of
Permit $
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
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 tho:t 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 cr in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
CONTRACTOR OR BUILDER
Signed.
sA ) ,
INSPE OR
In consideration of the issuance to me of this permit I agree to perform ire work covered rhereunde in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or ecijiCations submitted to e proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, m ?, . entiservant or
AUTHORITY