940 NE 99 St (10)MIAMI 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
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.
/f _ Date
Owner's Name and Address. ,M r ° A / L L / No
Registered Architect and /or Engineer
" fL ' r
Name and address of licensed contractor 1 l
9
°/3 J
Location and legal description of lot to be built on:
Lot Block ,Subdivision.
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of found tion Roof Covering
Estimated Total cost of improvements $ . P ® 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, 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 such subcontrac ors, on work to be performed under this
pennit, as are licensed by Miami Shores Village. j � ��
Remarks (Signed)
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Street N
19
STATE OF FLORIDA,
COUNTY OF DADE. J 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 facts
therein by him stated are true. c �
Permit No .. _ Date ' .
o S C
Disapproved Date
(Signed)
Building Inspector My Commission Expires
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 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.
1
JOB:
BUILDING
ELECTRICAL
PLUMBING
The following is ready for Inspection:
Inspector's Report: -
•
•
•
•
• WORK
4. DONE BY
: REQUESTED
•
WILL BE READY
Application 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 regula-
tions 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 ti+ i .r •
Name and address of licensed contractors",
Location and legal description of lot to be built on:
Lot_ Block_____ __r_ Subdivision_
Street and Number where work is to be done___�L�'
State work to be done and purpose of building (by floors)
Zone cubage required
STATE OF FLORIDA,
COUNTY OF DAVE.
ss.
Before me, the undersigned authority, a notary public, duly authorized
appeared
Disapproved
(Signed)
Chairman
Mem
Member f ;
Council Approved
APPLICATION FOR BUILDING PERMIT
Date
Building Inspector
tM IAM I SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
PLANNING BOARD
(over)
Date - -- — — - -- — 19
No._�
New Building =_ _ Remodeling Addition_ _ Repairs
To be constructed of_________ _____d_.___ Kind of foundation____ _ Roof Covering____
Estimated Total cost of improvements __Amount of Permit $____
��6_�___� _Plan Cubage
Distance to next nearest building_______ ______— _____— ______— _______Size of Building Lot ___ n� a y-
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 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 subconttactors, on work to be performed under this
permit, as are licensed by Miami Shores Village. !
Remarks (Signed) �
to administer oaths and take acknowledgments, personally
e
No. of Stories_
___and for no other purpose.
7
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. - 2 �__ Date 4 Read, Sworn to and Subscribed before me.
DATE
Notary Public, State of Florida
My Commission Expires
Member
Member
Member — — - - - - --
Disapproved _ —Date
rrections or changes to this application after approval has been obtained from
NOTE : A charge of $1.0( will be ma a for making
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.
LIST OF CONTRACTORS, SUB - CONTRACTORS, ETC.
REQUIRING OCCUPATIONAL LICENSES
MIAMI SHORES VILLAGE
15. Solar Water Systems.
1. General Building Contractor.
2. Plumbing, Heating, Ventilating, Air Conditioning and Gas Fitting.
3. Electrical.
Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators.
5. Excavating, grading, filling and Landscaping.
6. Moving or wrecking.
7. Septic Tank and Drain Field.
8. Brick, Stone, Tile, Cement Block, Concrete and Gypsum.
9. Carpentry, Millwork, Awning and Shutters.
10. Cement, Lime, Plastering, Stucco, Lathing and Cast Stone.
11. Decorating (interior and exterior) , Painting, Waterproofing, Damp- Proofing and Paper- hanging.
12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring not otherwise
specified.
13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors.
14. Roofing, Sheetmetal and Skyl' hts..� *
16. Well drillers.
17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc.
18. Structural and Reinforcing Iron and Steel.
19. Tile, Terrazzo, Marble, Granite and Cut Stone.
20. Electric Fixtures.
21. Illuminated Signs.
22. Bridge, Bulk- heading, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga-
tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work.
23. Every person, firm, co- partnership, Corporation, Association or other organization engaged in the bus-
iness of supplying, furnishing or delivering building materials for any construction project within the
Village Limits and not having a regularly established and licensed place of business in the Village.