909 NE 99 St (9)MIAMI SHORES VILLAGE, FLA.
N9 5575
JOB
ADDRESS
INSPECTION
TIME READY
e
REMARKS. (7(
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built one
Lot.__l, ! / Block. _../ c ff Subdivision
Street and Number where work is to be done
State vy k to l ne and purpose uildin (b floors)
, - �_
New Building 'Remodeling / j Addition
To be constructed of Kind of fourfdation
Disapproved Date
(Signed)
Chairman
Member
Member
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
etzrrf t A /1 /4 /�C,��z.
,ee 9;
Date
_
nd for no other pu se.
Repairs o. of Stories
Roof Covering
No 9 y Street
Notary Public, State of Florida
(Signed) - t
Estimated Total cost of improvements $ Amount of Permit $
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 pennit 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, Comppi General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance f m 11 contractors or sub- contractorf nployed by him
in the work to be performed under this permit; and will post or cause to be poster} for inspection on the site of the wgtk sbch public notice
or notices as are required by the Act. The undersigned agrees to employ only such subco actors, on° work to be �¢ermed under this
permit, as are licensed by Miami Shores Village. /
Remarks
STATE OF FLORIDA,
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 Date Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Member
Member
Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
ki Pt 1 ^
I
.... M. - .4 ...,.....,„........
711
r
MIAMI SHORES VfiLLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE 195
PLUMBING ❑ PERMIT N? 5082 Contractors
License No. /t.71/,.17J.),
ROOFING ❑
r Work to be performed under this Permit a ' ,'
Owner of " /
Building l R;� Lf
Architect
Contractor
or Builder
Legal Lot
Description
Address of t ,
Building
CONTRACTOR OR BUILDER
Bl.
Cl. 7*1
Subdi-
vision
Value of
Project $
This permit is granted to the contractor or builder named above to construct 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 that 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 or in the statements o - - •ecifications and that he assumes responsibility for work
done by his agents, servants or employees.
Amount of hr[
Permit
Signed F .; �",�. ., BY:
INS CTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this p�rmit I assume responsibility for all work done by either, myself, my agent, servant or employee.
1,
P
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Ir. apertr rt $ Repork ,
r " ~ JOB: AD:
WORK
DONE BY:
: :REQUESTED .
.
: . :
•
•
The following is ready for Inspection: -
WILL BE READY