FENCEDate Job Address / U/ /6( 3 /
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Permit Type(circle one): BUILDING
RK DESCRIPTION )4 )(7
5 VP �7
FEES: PERMIT 2p- ® 0
Zonin
Legal Description I U �I l;i w
/ Lessee / Tenant - -- - -- Master Permit #-. Jr
Owner's Address /4 C' 2 Z /1 /
Contracting Co e�
Qualifier SS# - -
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Square Ft.
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
rX/csli)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating - truction and oning. Furthermore, I
authorize the above -named contractor to do the work sta
APPROVED: Fire
Address
Tax Foliof/
Estimated Cost(value) "0 O
Signature of Con
Date: 4; /0//
tar ' as to Co
y Commission E
* * * * * * * * * * * **
RADON C . C . F . , 5 NOTARY .l ; P 0 TOTAL DUEg ; ,5
Other
Electrical
Plumbing Engineering
Mechanical
Buildin
Phon-7 / 3 s-$-q
Phone
A ctor or • er- Builder
MIAMI SHORES VILLAGE f -o5 '
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the npproval of the detailed statement or tote plans and specifications herewith submitted for the build •
ine 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. \\
Date ...— .— ....� _.J�_...... -•— . r19••�: --
Owner's Dame and Addres -t s .. C . ? : � . —. No .. Street �. \ 6\ 5 _
�
Registered Architect and /or >yrngineer
Name and address of licensed contactor C- _. �v:r:�.. - �S`` t ` C'� =- • - •••• 1• »�� » »�
Location and legal description of lot to be built on: // � eZJ 0 r°
Lot - ?.' 1' Block \ Subdivision \t tom"• ' ._
\n�'T .' �. ._
Street and Number where work is to be done \NOG sass.
� o
State work to be done and purpose of building (by floors)
Disapproved ....�� �� . :.( ate
(Signed)
Building Inspector
., ,....,,•,m,..,.....,•.•..,...,, t,.,..,
:�...��! .� -�.:_� _sass__— .- - -• ---
and for no other purpose.
New Building Remodeling Addition Repairs
To be constructed of Kind of fokndation Roof Covering
Estimated Total cost of improvements $ 'L W
Amount of Permit $.10
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 swith 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 inspectio the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such work to be performed under this
pennit, 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 stated are e .
Permit No.._ 741 .. Date 41 Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires —
No. of Stories _
to me well known,
PLANNING BOARD DATE
Cirainnan Member
Member Member
Member — ....._......_..._.— sass._
Member •_ _•• »•••••
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re-inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
'�,]�. �'� �} 1•."' n.�. '• '�n�f � ��•IA4� s. -..r . y�, �f�.��n `3!.! .� � '� �i,.i, C• �'.
i_-- ..-= '- •�'"a' ° � ,SKE OF :SURVEY
<i4-1 ; ; r r Lot R • '�l , ock l� ,, TAi 1 1 ,SA C, P .RF
S TA 6 agcorc in ;;tor : I� P .the ,eo
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s t;, r I d n r t a• ,
E e�s:reegxded ill I l at gocflt,' ot'
n ;P� 5'�? 'dc cri.bed p,orti Gf; L r 4f 'said
r �, B1b eg n. at the [orthwes corgi
:I � r � ', r. � X 77 ,, 1�`' a •s
..• ;, ' r,qf a1 ,Lol;f . t.,hencee rear :asoutt}. 8 de-
t tie:' des er1y , Rine o•f .sai$ Lot �t�.. :.
; e to then SSou1 r1w u
esL earn
s ai d ° Iot, 4 ; , thence{ run ,Ea;terl' aloe
t F K the p are .df :• a ei.X.CU�;dT curve to � he:
r s rt 'ha*ing fir Sts e1.rnentr a ": radiu
f +� 6 Peet.. arid a 1 central .angle
h ;d
Oegrees l minute X53' seccnas
€O .•feet `ry }saidc3;r'cular curve
�•4t'.' w r t , ��, h ,
e toutherly-?liz of said Lot
th 4LTun?,tZ.prthxF3 c;e g rees 3X1 min-
F' 17 seconds 0est .;P4r°a11e1;,•to and
10, 040.4 0t . s g.,, • the `'Westerly
'egad for`; "135o:2d .f,e:et .t
g;::}�o1n ' ou 4he:'A�or. h�erly li e. of said
ALot 4,; sa1d Northerly., line being a
eri roular''curveth'ence dun .
9ng ,, the. :.4rc , ct , a . circular: " curve to
', �; `L he r, �ht, ' having for .its 'elements : a
raditxs pf •648;,66 felt and a, ce}tral,
` seeon
t p i e 'Point. of De-
K girin1rtg.._ `. W
P?`c.P 'frty I s
- :>r veyed :a
• er
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is red losnd ")6,.urv