1974 Garage Enclosure.Application is hereby made for the approval of the detailed statement of t
in or other structure herein described. This application is made in complian
Shores Village, Florida. and all provisions of the Laws of the State of Florid
regulations of the Building Division of Miami Shores Village shall be compli
plans and specifications must be kept at building during prggress of the wor
Owner's Name and Address g ( eo- W 3
Registered Architect and /or Engineer + / • r //I'VE S A u ( ( ti
Name and address of licensed contractor C.W.A./-? 1.1 .7- .! . h
Location a d legal description of lot to be built on: 0
Lot Block Subdivision "~
Street and Number where work is to be done ...._.........
State work to be done and purpose of building (by floors)...
.R.,._i( � � , a p.
Permit No.
MIAMI SHORES
APPLICATION FOR BUI
BUILDING INSPECTION D
Date... - ( �
PLAN INC BOARD
Chairman
Member
Member ...... - -.-- -_..._.�.__._......
mbcr
Member
Member
LLAGE
ARTMENT
ING PERMIT
plans and specifications herewith submitted for the build -
and conformity with the Building Ordinance of Miami
all ordinances of Miami Shores Village and all rules and
with, whether herein specified or not. A copy of approved
ount of Permit $
an Cubage
ze of Building Lot
Date.. _
No. .•n r11' . Street. • 6
l e er. ezefs
Repairs No. of Stories
Roof Covering
( 2. 7 �c2 = =...
New Building Remodeling N' Addition
To be constructed of Kind of foundation
Estimated Total cost of improvements $ e
Zone cubage required
Distance to next nearest building
Maximum live load to be borne by each floor
I hereby submit all the plans and for buildin All n$tI es 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 cinder this permit; and will post 'or cause to be posted for inspection on the site of th work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such sum' tr k to e per reed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
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 - —
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 st pd are true.
Read, Sworn to and Subscribed before me.
DATE
and for no other purpose.
to me well known,
Disapproved Date .. _..___.._____._..__________
`∎ / / Notary Public, State of Florida
(Signed) � �
My Commission Expires
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 frrnn
the Planning Board.
A re- inspection fee of 31.00
materials and /or workmanship.
will be charged when such re- inspection is made necessary by improper notice for inspection or faulty