FENCEMIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby uinde for the approval of the detailed statement or tile 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.
ff)� // DOWN/5K Date... Os.ncr s Tame and Address ...... �r7`r
Registered Architect and /or Engineer i . ••. ,, . ..<.
Name and address of licensed contractor... .. ... ..- ..._._. f:...._ ....... ......
.................... _.._.
Locatio and legal description of lot to be it on: rr /� Q Q� �/ / J/j GG �I 8
Lot ...., Block ....... f ij j'jj/ u iv' n.... F.VI5EIr '.1L L ✓ SECTIO ` .__
Street and Number where work is to be done 11.'i (2. ����, .
State work to be done and purpose of building (by floors)........ ._FI .. te IN gEraic .
I hereby s
be sent to..
Disapproved
(Signed)
"I'IJ�JC
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Date.
Building Inspector
New Building Remodeling Addition Repairs
No. of Stories _
To be constructed of Kin f j v 1ation 5 oof Covering
Estimated Total cost of improvements $..... •• U Amount of Permit S.
Zone cubage required .Plan Cubage .h . Distance .to next nearest building Size of Building Lot.. / r .4.
Maximum live load to be borne by each floor
and for no other purpose.
streetLYE J ag 2 _�
pecifications for said building. All notices with reference to the building and its construction may
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,
anti has complied with the previsions 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 inspecti on the site dill work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such s tr $ on work t performed under this
pennit, 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
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
thcrcin by him stated are true.
Permit No.._... t 19_ 2 \ Date D6' ). 1 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires _.........._ .... _ _
PLANNING BOARD DATE
Chairman Member
Mfcrr.ber 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 Pl. Board.
A re-inspection fce of 31.00 will be charged when such re- inspection is made necessary by Improper notice for inspection err faulty
materials anti /or workmanship.
fob `Jo. SBR ? /D - 3�
Property Address: // `9 - � O .� r Date: 41-- /2
Surve of G D r
Subdw ,stun
r d 2 c s, _ . c 1/ c A7
According to the Plat thereof recorded in Plat Book f at Page�of the Public Records of Dade County, Florida_
Subject to all restrictions, reservations, easements and Right—of—Way of Record.
A-IS /D T " ST
h
Flood Zone: 4-
Mortgage Survey Certified lo: •J+�,.:1 ittcshL / .j/ , G
NOT VALID UNLESS IMPRINTED WITH AN EMBOSSED SEAL
For : 4 L ,4 ,C! D D ,M,C3 2 D !.L-,e f'
/mo Ja' T fa
a� j ' -6.9 /e l `-"\
in Block /
Note: The survey of the property shown hereon K in accordance with the description furnished by - �r/h✓' .U" t ')J YL'C
no search at the Public Records has been made by this office for accuracy or omissions.
I HEREBY CERTIFY: That the attached SKETCH OF SURVEY of the above described property is true and correct to the best of
my knowledge and belief as recently surveyed and platted under my direction; also that there are not above ground enchroachmenls
other than.those shown, and /hat it meets the requirements adopted by the F. S. P. L. S. and the F. L. T. A.
L-ANDA AMT CSO Ve ING INC. •
Af'iISTit)rS FFIVERA
REG. LAND SURVEYOR No 63
STATE OF FLORIVA
MIAMI SHORES VILLAGE
BUILDIN' INSPECTION DEPARTMEN
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the det.. iled statemen of the plans and specifications herewith submitted for the build-
ing or o h, r structure her 1., described. This q-plicatio. , is made in compliance and con•o•m•ty w•th the Building Ordinance of Miami
Shores Village, For:da, and all pro• isions of the Laws cf the State of Fkrid. all o d•nances ,f Mi •mi Shores Village and all rules and
regulation.; of the Building Div.: i of aam Shop iilage 1- '1 e ^o, ipl.ed with, whether herein specified or not. A copy of approved
plans and specificati , n , must be key.' at building durin progress of tl.e wcrk.
y Date Weenj .P i a ,195
Owner' Namd and Address E?' ' .E. /1L E k' No._/_L f f._ ____. Street_. 14,e: _ o�i FT
Registered Architect and /or Engineer._.
C
Name .nd address of licensed contractor.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Permit No Date
Disapproved _ Date
(Signed)
. /4/e
Location and legal description of lot to be built on:
Lot_ Block.__ ___.. Subdivision
Street and Number where work is to be done_ .1,99 ,NAG 9f !' ''Es
State work to be done and purpose of building (by floors )
9 e -, Cbe,9 _,,„ 4ia,s / 1vC�-
and for no other purpose.
New Building Remodeling_ _ __ -_._ ... Addition____.___ ___ _____ __ _ Repairs. _ _ No. of Stories. -- -
,ta1 cost of improvements $__. ® 1h'j _ .
To be constructed of __ _ Kind of foundation Roof Cov sing__
Estimated 0_ -'�' Amount tf Permit $__
Zone ..- ubage required_ __. _ _Plan Cubage . _ -
Distance to next nearest building__ _ _ . _ ___Size of Building Lot
Maximum live load to be borne by each floor_
hereby submit all the plans and speciiications for said building. All notices with reference to the building and its construction may
be sent to.
The unde signed appli :-ant for this bulding permit does hereby certify that he understands and accepts his . bligations as an employer
of 1: bor under he Florida Workmen's Compensation Act being S•:,'tion 5966. Coi pled Gen al Laws of Florida P -r anon. Supple nent,
and h is complied with the prov lions thereof, and will require similar compqance from all contractors or sub - contractors cmplo-•ed by him
in the work to be performed under th;s permit. and Al post or cause to be posted for inspection on the site of the work su.:h public noti• •e
or i•otites as are required by the Act. The u:,d.•rrign• -d agrees to employ only such be• egc,ors, on work to be perforn, d der this
permit as are licensed by Miami Shores Village, Cleoaa/ Ft er "hea
-
Remarks (Signed) '
Building Inspector My Com :nission Expires_
• PLANNING BOARD DATE
Chairman ...- Member
Member ____. __ _ _ ______ ___ __ _ Member
Member ._ Member
Council Approved. Date Disapproved
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally p p-
peared - _ -- --
and who, being by me first dAy sworn, upon oath depopes and says that he is the .
of th abov. described .nstruction. t: : h: has careially read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are trie.
Read, Sworn to and Subscribed before me.
Notary Public State of Florida
to me well known,
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application tftrr approval his been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection • is male necessary by improper notice for inspe :•t';m or fa. Ity
materials and /or workmanship.
.h�
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