FENCEBUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade for the approval of the detailed statement or 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 progress of the work.
Date..
Owner's Name and Address ..�/!lr T ' F ZL .•... .. _ No. . . ._...(/.)
Registered Architect and /or Engineer ...... t, j � �/ /� ,• . **+n *••
Name and address of licensed contactor ...ellr't a f!t.� 0 1 17. _...
Locatiop 7 description of lot to unit on: /� ' 6; iver4 . S 3 _. 10 .;7 Lot••••. 7 Block (s Subddivvi sioon.!.'I..rC�['!. !!�ll/'^�` � ._.__ _
Street and Number where work is to be done... (. D, p. iY.Ef /451 S ...•_._... _ ..._.. _ c.
State work to be done and purposc of building (by floors).. iof �[1
. .. - a .ally
and for no other purpose.
New Bui lding ..X.._..._ ............... Remodeling Addition Repairs No. of Stories. _
f Covering ...... ....._.. --
To be constructed of Kin�„ foB8dation �
Estimate Total cost of improvements $. • D Amount of Permit $.
Zone cubage required plan Cubage / J�.t.
Distance .to next nearest building.. Size of Building Lot 1 0 i .I t
Maximum live load to be borne by each floor -• • •••••••- •••
i hereby bmit all the glans an p ificatio s forr �� b / u'1 i All ,notices w i r elnee to the building and its construction may
be sent to.. C �LtI.. gI,.tG. (•A G WA( ZJ. 5.la /.1
The under igned applicant for this building permit does hereby crrtify 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 hint
in the work to be performed under this permit; and will post or cause to be posted for inspection on site of the work such public notice
or noticcs as are required by the Act. The undersigned agrees to employ only such su • . • a- •rs, • w.rk to be • - formed under this
pcnnit, as are licensed by Miami Shores Village.
Rem.uks..._ (Signed).. .
STATE OF FLORIDA,
COUNTY OF DADE. ss'
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 true.
Permit No..___ .. ..... 0 Date Read, Sworn to and Subscribed before me.
Disapproved ,..� .e -. -• •• Date..
(Signed)
MIAMI SHORES VILLAGE
Building Inspector
r
Notary Public, State of Florida
19.
. Street.ME!...71..
My Commiuion Expires .........._. —
to me well known,
PLANNING BOARD DATE
Chairman Member
Member 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 I'Iannir.g Board.
A re- inspection Ice of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
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/4 44'
N E 98 ST
906
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LOCATION MAP
SCALE
ORDER NO. 8492
F.B. 336, Pg. 7 -8
SKETCH OF SURVEY
SURVEY of Lots 6 and 7, of Block 78, of MIAMI SHORES SECTION NO. 3,
according td the Plat theroof recorded in Plat Book 10 at Pagc, 3' of
the Public Records of Dade County, Florida, being situated in the
Village of Miami Shores. •
WE HEREBY CERTIFY: that the attached SKETCH OF SURVEY is true and
correct to the best of our knowledge and belief as surveyed and platted
under our direction in May,d1986. We further certify that this survey
complies with the minimum Technical Standords for Land Surveying in the
State of Florida, Chapter 472, Florida Statutes.
A. R. TOUSSAINT & ASSO 'IATES, INC.
LAND SURVEYORS
620 N.E. 126 Street; North Miami, Florida
DATE: May 5, 1986
SCALE: As shown
By: t._ V. Pres.
owar• C. Gas. e
Registered Land Surveyor No. 1683
State of Florida