FENCEApplication is hereby mode for the approval of the detailed statement ui inc 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 prpgreu of the work.
I IAA
Date...—---4. L ... L. _....__. _ —. ,19 b
M e,
Owner's Namc and Address .i C'� QLZL3 ._ .. »_ No...._ .c.'. .. Street._.r`3.. q'
Registered Architect and /or Engineer ,,.,. .,.•••...•. „.,.,•..,
Name and address of licensed contactor 714 - L e- • __ . S 6 '4.-9— . •..1 p l--P`i 4-f R?l44
Locatio and legal description of lot to be built on: �/� �j9 /
Lot..... C,-- 7 Subdivision. . ... �[�- ' 1 i-fM-_._ -5'41 e .1 j. 1 At7 f�
Street and Number where work is to be done .Q_ N1 _ e"" )? ..— . ..__N
State work to be done and purpose of building (by floors) 654/1 '-' 42 G /IQ L l k..,
{E 4.1-0 Kt 4 40 t T 4 -sT S I C7 S m•p pee)
fl, .... ;(' LF O P r "eqGE ... 5 w,VD Lye' t7 and for no other purpose.
New Bui!ding Remodeling Addition Repairs No. of Stories _
To be constructed of Kind of foundation _ Roof f.overing
Estimated Total cost of improvements S CPV 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.. 4-9. .... L--K1 i4-/ -4F, P'1__: 014
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 %Vorkinen's Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement,
anti has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
:n 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 such su ntradors, on work tube performed under this
permit, as are licensed by Miami Shores Village.
�2S
STATE OF FLORIDA,
COUNTY OF DADE. I ss.
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 fads
therein by him stated a true.
_ MI ( � (VA' Permit No..* , Date 1 b Read, Sworn to and Subscribed before me.
(Signed) 4,
Disapproved }.. • , ' . s ate .._..
Notary Public, State of Florida
PLANNING BOARD DATE
Chairman Member ......._ ...................... -
Member Member
Member.. .. _....._......_..._._ ...._....._ Member ...__ ._...._ --•-
Council Approved Date Disapproved Date
NOTE: A charge of 51.00 will be made for making corrections or changes to this application after approval has been obtained from
the Pl.innir.g Board.
A re-inspection fee of 51.00 will be charged when such re-inspection is made necessary by Improper notice for inspection or faulty
materials and/or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Building Inspector
My Commission Expires
-
FIRE DEPARTMENT
;PUBLIC WORKS
I OLICE DEPARTMENT
L
N.
UILDING DIRECTOR
«\
ANNING & ZONING BOA„D
LAGE COUNCIL
HESE PLANS ARE APPROVED FOR ISSUANCE OF A BUILDING PERMIT
L7 WITH NO VARIANCES ❑ WITH VARIANCE(S) LISTED IN "REMARKS"
NO OTHER DEVIATIONS FROM THE MIAMI SHORES BUILDING AND ZONIN'
ORDINANCES WILL ;3E PERMITTED, UNLES: SPECIFICALLY LISTED BELOW
ALL OTHER APPLICABLE STATE AND COUNTY LAWS MUST BE COMPLIF '.
WITH BY ALL PAR i IES.
Autho'i7e'1 n
RELIMINARY:
EMARKS:
APPROVAL
FINAL:
D . t�
COM LIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED
BY AMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER &
SUB ONTRACTORS " !1' . VOW! F' .F �F ti i MN' U.
ING GULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN.