FENCEMIAMI 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 build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shares 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 specifica :ions must be kept at building during progress of the work. ,d
//�� Date / .� f 5�
U Owner's Name ark Addres .. D �� L �'YA 1 _ E=.. No. r `� E
wrn / _ . ... Street._ -. SEA', S.T..
Registered Architect and /or Engineer
Name and address of licensed contractor.. #1.15 A/ .<t1' E.- i 7,. ` c C 43 D 3
and legal description of lot to be built on: �j
Lot 2_ ._'l... -- ..._... Black ! i! ..... . ... . . .. . Subdivision .... /�i.4. 11/ i Hi4E .3
' Sr
';tr and Number where work is to be done � .J �_G_...___ __�Td•
State wr,rk rr be d ^A and purpose of bx.;Lling (by floors) f' G4ti.e t/ 4 •4,11' - Ne
Chairman
Member -
Member . ..
and for no other purpose.
;i. M Bu dine Remodeling .......... . ... ... Addition.... Repairs ... No. of Stories
ii be cor:stn',_ted . f ... . Kind of foundation.. _ Roof Covering
Estimated Total co;t of improvements $ Amount of Permit $.
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 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 the work to be performed under this permit; and will post or cause to he 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 such subcontractors, on work to be perfonned under this
permit, as are licer sed by Miami Shores Village.
Remarks (Signed)._
STATE OF FLORIDA,
CC;TNTV OF DA _)E. ss
Before me, the undersigned authority, a notary public, ~uly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly swum, upon oath deposes and says that he is the . . .
of the above desenhed 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 s-/ 1 ' Date 4 Read, Sworn to and Subscribed before me.
Di sapproved - ---- -.-- .:- . -- A Date
(Signed) .. _ .......... . `. ``
Building Inspector- My Commission Expires
PLANNING BOARD DATE
Council Approved Date Disapproved
(5
CHrls T, /N Fe CP. _Tit" c ,
Notary Public, State of Florida
Member
Member
Member
Date
NOTE: A ch: rgc 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- inspec•tio r fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials .iud /or w ' ip.
6 78 „, Sr.
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mactwou. ❑
ROOPNG a
gout- 0
Hof
Building 4 . Vi4.1 4 t 44. a : rte " e.. s..
Architect ` % ` S 7C
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N? 7977
Contrac
or uilder ' w ,t . C. at; n / r' .; . e."iC , e- r:
Legal Lot
II 81. S -
Descriptioa . ; Xision
so. vt
Address of Value of
Building ++� 1-1 L 51 Project $ ''7
�t��• 5 . y p
MIA I S R -B ViL..LAI3E. FL #
DATE- ;
Work to be peeioemed under this Pero*
• . Isl, ut a t r
Amt. of
Permit $
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
j un i or iu :t:;:.: ; »i j1 ..p • ith all ordinances pertaining thereto and with the undemanding that the work will be performed In compliance with any plans,
drawings, statements or ape if cations that may have teen sw,,.ati -' t aird �ynvad by the proper municipal authorities. .This Permit ma which this permit
r d at any s
time if the work is not done in oomph's= with such ordinances or if the plans • are changed without authorszauuu, ,,A ..;,.„ --
granted is the understanding that the contractor or builder named above assumes the responsibility fora ge ; d the ordinance and regutanons
paW. to the work covered hereby whether shown on the plans or drawwings or in the : , or and h f assumes responsibility for work
done by his agents, savants or employees. /1... '; r
Signed. Psi,
INSPECTOR
In consideration of the issuance to of this permit I agree to perform the work covered der in compliance with all ordinances and regulations
pertaining thereto and in strict conformity the plans, drawings, statements or speaificetions su to? the proper authorities of Miami Shores Vi1s
In accepting this permit - aetugtt yes (for all work done by either, myalf, my agent, servant or employee.
OOtITRACron-os' BUI M BY
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job /address 76S NE G Tax Folio
Legal Description Historically Designated: Yes No
1 /Lessee / Tenants 6C i y4-0 Master Permit # 99,5
Owner's Address 6 NE, l 3--1--. Ph no e <�C�J q 5Fs
Contracting Co. 0W `(\ Address
Qualifier SS# - Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING EJ.�C�TRI PLUMBING MECHANICAL
� / ROOFING PA SIGN
WORK DESCRIPTION �� NO( 1 Q CSL A2 l 2 °f- A-111, C
17 l /,� -�-�- b 4\ [pf# KSL Jo � ;r� �P Q — �- -fo —.
�quare Ft. Estimated Cost (value) 41 IOW
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be perfonned to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I cert: fy that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do , work stated.
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
RADON
APPROVED:
3A
Zoning ,r Building
Mechanical
C.C.F.
<*0 l Ili / 3/
ttLreo f CQntractor or Owner- Builde Date
Y f a o-- s11 -6 - 9 1 � - 0
otary as t Contrac or • er -Bull . er t ate
My Commission Expires:
Plumbing Structural Engineer
OFFICIAL ?r0' AR 3FAL
O � P RV PUB(' ANGL`•I_A M BECKER
-4„ 1�!q (1 COMMISSION NUMBER
j , Q CC766697
.t.Q my coMMISSION EXPIRES
OF F NOTARY S' BoND NOV. 15,2002
TOTAL DUE
'2$lectrical
5' -0" MN(
II
2' -0" � -I1
_
a
WOOD FENCES
4" X 4" Wood post
2" X 4" Wood Pall
I "X6 "orI "X8"
Wood Pickets
—
3' -0"
2915 Fences
Wood Posts
4' -0" High or Less = 6' -0" O.C.
5' -0" High or Less = 5' -0" O.C.
2915.1 Wood fences, so located on a property
that by zoning regulations they cannot be used
as a wall of a building, shall be constructed to
meet the following minimum specifications.
(a) Fences not exceeding 5 feet in
height shall be constructed to meet
the following minimum
requirements: from nominal 4 inch
by 4 inch by 8 feet -0 inch long
posts spaced 5 fee. -0 inches on
centers, having a fiber stress of
1200 p.s.i. in bending, and shall be
embedded 2 feet -0 inches into a
concrete footing 1 foot -0 inches in
diameter and 3 feet -0 inches deep.
Other components shall be
designed to comply with the
provisions of this Chapter and
Chapter 23.
(b) Fences not exceeding 5 feet and 4
feet in height respectively shall be
constructed as provided in
paragraph 2915.1 (a) herein,
except that the spacing of posts
may be increased to 5 feet -0
inches and 6 feet -0 inches on
centers for these heights.
STATE OF FLC RIDA)
COUNTY OF DADE)
The undersigned Affiant, Q ( 1 54j AC ' 1 � + v , does hereby attest that the
(property owner)
attached survey, performed by
AFFIDAVIT
rt5ta
(name of surveyor's company)
performed on (luck?). Ng', is an accurate representation of the existing conditions and
(date of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Witness(sign anc print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this day of
Affiant is pyrsonally losown to mek" produced ODD s11— /S' ( (VS' - C as identification.
No
OFFICIAL NOTHR? ;EAL
♦PRY PUe ANGELA M BECKER
2 l ri i( COMMISSION NUMBER
% IjI. CC786697
1 , O d d MY NCOOMVMISSIONZ PI FS
OF
f,.
� ......,... ••* •
) SS.
COUNTY OF MIAMI DADE )
STATE OF FLORIDA
The foregoing instrument was acknowledged before me on by
, who is personally known to me or who has produced
as identification and who did (did not) take an oath.
Signature of Acknowledger:
Name of Acknowledger:
STATE OF FLORIDA )
) SS.
COUNTY OF MIAMI DADE )
(ACKNOWLEDGEMENT - INDIVIDUAL)
Title or Rank:
Serial No.(if any):
(ACKNOWLEDGEMENT-CORPORATION
The foregoing instrument was acknowledged before me on by
, of
a corporation, on behalf of the corporation. He/She is
is personally nown to me or has produced as
identification and did (did not) take an oath.
Signature of Aclmowledger:
Name of Acknowledger:
(Typed, Printed, or Stamped)
Title or Rank:
(Typed, Printed, or Stamped)
Serial No.(if any):
? e
50 .
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1774 W. Flagler Stree
MIAMI 35, FLORIDA
Telephones: 9 -3508 82 -0027
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;ORDER NO:
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1 HEREBY CERT( that the attached sketch represents
a survey made un t my direction and is true and correct
to the best of my knowledgerand belief.
There are no encroae as show_
REGISTERED LA TD SURVEYC R$'r.? . ?
STATE OF FI4RIDA
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According to the Plat thereof•as recorded in Plat Book / O
Public Records of Dade County, Florida.
For ''•f.:- *,=£: • Date . � pr .. / (J /
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rT / Z•', co cU.ri.
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