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MECHANICAL PERMITMIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade 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 Villa$e shall be complied with, whether erein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. D ate. ,19 71 Owner's Name and Address O L1 SS .._ 0)64) H a 4eii o �� ._ • Street _ . l ~ S 1 Registered Architect and /or Engineer ,Qq Name and address of licensed contractor C [tali L ..... '1 14 - Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done /1. O /-t State work to be done and purpose co_ry o / New ui!ding To be constructed of Kind of foundation Estimated Total cost of improvements $ 2 4 ©' 0 r� Maximum live load to be borne by each floor STATE OF FLORIDA, COUNTY OF DADE. ss of building (by floors) .6 bl/L y . I f GO a2 — sre- _.._. . ....... 4.r.0 Remodeling Addition Repairs No. of Stories Amount of Permit Si. Zone cubage required .Plan Cubage Distance to next nearest building Size of Building Lot D0,:.78 L t -fr-- �Z-Rrt -rev -•Sjr7 ✓wt ..s. 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, Pennanen implement, and has complied with the provisions thereof, and will require similar compliance fro,. .11 •. tractors or sub - contractors en )dyed by hint in the work to be performed under this permit; and will post or cause to be posted •r in.p ction on the sit -oft ark h uhlic notice or notices as arc required by the Act. The undersigned agrees to employ only suc su. tractors, on o to i .. f. . under this per nit, as are licensed by Miami Shores Village. Remarks (Signed)...... 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 are true. Permit No 420 `� Da e Zr ' ead, Sworn to and Subscribed before me. Disapproved a __....._.._... . / (Signed) Building Inspector Chairman Ucrnbcr Member .. PLANIQINC BOARD DATE o4//01774. y tic Member Member Member ...._ ._ silos CS p L fJc&" oc.D N .... ttAr X 4 f .. .- and for no other purpo Notary Public, State of Florida y Commission Expires to me well known, 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 rc= 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. r �o►� l -17 Does 113 JO 5) / 4 / , V 7 / . b frvn i 08110/.0 o,,g,1c11‘) i )7T-C--N P /,7 A) p0 c o o lvi • reoo I IfP fo�PI _ P Ne/ N t (z �lR '31v1 1S_ t7 OZ 1 Obov6- cE -,L/N �T/ 1./A/ I5_ C /, /916 _ t L0 (120 N n Ij r>4,0 - R 11, 1-o //vP M atiM] / c f/oe? g s. L v /t //4h / y 5125-1s A Bey w s / v 4 geto R o ots t � 7 (DES DAY fl 11 'IRA TRfra‘ G?, v ea c /ft y.ToN ffrw edit-15 Al IRS / o , t ti E47 f, c// L• u ,n,4/� Coa (/ 7 "in�G ci" /s , `Lv . J D � Ac Ac- p Q4RE0 oa Cie Ci" f i9 e2 r - 3 -- R6/1467 'T/z)3 ti E . C o N 06 /u S i AV ' evil ,5 I s tNl t.6• pi P 56 a50 t /c(-'