FENCEApplication is hereby utndc for the approval of the detailed stateioem ur the plans and specifications herewith submitted for the build •
inc 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. p o
/ a� - Date/2 01 / _2.3._ 1
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� �, ... ...,ff .d !!l1.. S O ,t _ •No 2 . eet .._._ sfr
Owner's Name and Address ...... .. � 1�.._... Str /
Registered Architect and /or Engineer
Name and address of licensed contractor .(Q /... /.. . 4. 5_..._Fe4/ c c.. 0 . .s,3. D �' �. 7 Sf.
Location an legal description lot to be built on:
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Lot? E 2 : A. 9 . 7 ' i 01 lock 3y- / Subdivision .........,�.[_.. z /� . 0 , 70
. Street and Number where work is to be done ...e�. ....1./..r.. J
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l.
State work to be done and purpose of budding (by floors) 7 .. 1151 CA ..t . ..__L...L! P k Feiii C L°-_
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of found� on Roof Covering
Estimates Total cost of improvements $.. /�mrr Amount of Permit S... 6
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
Tile undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation's as an employer
of lAbur under the Florida Workmen's Compensation Act, being Section 5'')G6, Compiled General Laws of Florid a,,'Yerinahe•nt Su„i)lenient,
and has complied Stith the provisions thereof, and will require similar compliance from all contractors or sub- cnntru ctors? employed b ,_hinr
in the work to be. performed under this permit; and will post or cause to be posted for inspection on the site of the ul:lic once ' 1
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work t9 - be pelf ed tm•er: tIiis /
permit, as are licensed by Miami Shores Village. ■ ;'6' >-
Remarks
STATE OF FLORIDA,
COUNTY OF DADE. } Ss.
Before me, t c un
pealed ....... a
Permit No
Disapproved ...
(Signed)
rsigned authQri
3 ,/�`�J
MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Date
Date
Building Inspector
BUILDING INSPECTION DEPARTMENT
l\ 1
Chairman
N1embcr
Member
Council Approved Date
NOTE: A c•h.irgc of $1.00 will be made for making
the PI.urniog Bo.vd.
A rc!in fee of 51.00 will be charged
materials and /or workmanship.
(Signed )1i
My Commission
Bonded th Maynard
K� ?a 'Pc
a notary public, duly authorized to administer oaths and take ac nowledgments, ' nally ap-
and who, being by me first duly sworn, upon oath deposes and says that he is the. S
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 e true.
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires r
PLANNING BOARD DATE
Member
Member
Member
Disapproved
corrections or changes to this application after approval
to me well known,
Date
has been obtained from
when such re- inspection is made necessary by improper notice for inspectiom or faulty