MECHANICALName and address of licensed contractor
STATE OF FLORIDA
COUNTY OF DADE.
1 SS.
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 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 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 TO 0, PJ 1 A s 0
Registered Architect and/or Engineer
h ► P rn i t 1 S I� ` f ‘ ePD " 904f -44 S
Location and legal description of lot to be built on: Q (�
Lot jJ� Block / .2 � Subdivision Q ' • O 7/ 8,7
C 5 .e V 7/
! / Q /A L--- Street and Number where work is to be done / /A L--- / 9 S T." 5"
7 O
State work to be one and purpose of building (by floors), state exterior colors (submit samples)
1 4,
e I c-e. C.Q Nric A I AJ C, f ke/vT r
S - r c - /ol <w h.kA - \
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements 5 00 • 0 v Amount of Permit $ 7 / • L Sr
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 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 obligatons 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 subcontractors, on work to be performed
under this permit, as are licensed by Miami Shores Village. -7
� �2i:,� e t` iJl� :L7/ CA
Remarks (Signed) /• /
Before me. the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared
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. of / c. Date Read. Sworn to and Subscribed before me.
Disapproved a \I • 0 _ Date
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved 1 ate Disapproved Date
NOTE: A charge of 525.00 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 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship.
Date /5/_
No. 9 r Street
Notary Public. State of Florida
and for no other purpose.
to me well known.
1 4
MIAMI SHORES VILLi GE, FLA. N? 6138
C;(2.t P Q,,
Jos � �� 6 � 6 A-= � ..c.,
ADDRESS 1. 2
INSPECTION C_ e .�1 V ,4_
TIME READY / 0 / —6 C 4
REMARKS •
INSPECTOR
DATE
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
EW
Architect
Contractor
or Builder
Legal Lot
Description
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
Work to be performed under this Permit_ -
B1
N9 5795
Address of Value of Amount of
Building Project $ II Permit $ t
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 applica-
tion 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 or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed, INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordhillltt es 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 permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
DATE. 1
Contractor's
License No.
19
/
Subdi-
vision
BY AUTHORITY •..oT
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MIAMI SHORES VILLAGE, FLORIDA ��
0 �
DATE 19
o PERMIT N9 5891 Contractor's 1 License No. t 4 • ' )
0
❑ Work to be performed under this Permit L r a • c—
Owner of
Building
Q
Architect
Contractor c ..� or Builder `` 1 1 C
Legal Lot Subdl-
Description I Bl vision
dC _ : Value of II Amount of
Address of
11 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 : pplica-
tion 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 or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
CONTRACTOR OR BUILDER
Signed. t..._ % -� - _.. _ '.._S; INSPECTOR
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 as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY AI SOT
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 Law. of the State of Florida, all ordinances of Miami Shores Village 9nd all rules and
regulations of the Building Division of Miami Shores Village shrill be complied with whether herein specified e. not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date - /o_. _I
Owner's Name and Address S• Hoa Ti CK_____ _ cr__C7!? —__805 G* - - __ -___ ____ No._ ?'r ___ _ Street_. N_ }° ._ .77
.ST _
Registered Architect and /or Engineer nn __ ..
Name and address of licensed contractoiC_RPALA —F3' 4.a2.— 0 15.4u 7/.o,gJ_N___Si____ ..- 4 _ _ /-47-74 G , J "Lc_
Location and legal description of lot to be built on:
Lot_ Block Subdivision
Street and Number where work is to be done_77? ,t1,__ '_ 77
State work to be done and purpose of building (by floors) .. To ', et.i _ti" • 1 81 A. C e,i__q 4 I o • f _, r �_
�SZr
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering al ` Estimated Total cost of improvements $_2. Amount of Permit $ 1O
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 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 ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks
STATE OF FLORIDA,
COUNTY OF DADE. ss
( Signed ) .�._�
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgnents, 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 5 ? ? Date /0 ' G —it, y Read, Sworn to and Subscribed before me.
Disapproved Date
co ( (3 �-c e
�"' ""` Notary Public, State of Florida
( Signed)
Building Inspector My Commission Expires
PLANNING BOARD____... DATE
Chairman __ __ _ ___ _ _ . Member
Member _ Member
Member Member
Council Approved Date Disapproved
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.
Date