BUILDINGBUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor ; 7
or Builder
r
Work} to be performed under this Permit
CONTRACTOR OR BUILDER
PERMIT N? 7062
MIAMI SHORES VILLAGE, FLORIDA
DATE
Legal -
Description
Addre of 7./ mss/' Va,ue of ,e� Amt. of
Building Pro'ec / (¢ Per �+ ' ....�,
This permit is granted to the contractor or builder named above to construct the b ding or to install the equipment or devi • described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be perfo d in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. his Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes ,the resp sibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or e statemer;ts,or specification and that �lie�a� respon-
sibility for work done by his agents, servants or employees. } y+' . , � 1.� If+' t =am'
Signed. • ' INSPECTOR By
In' + 'deration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations :;
pertainin. ` eto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village'. .
In accep ' g is pe me responsibility for all work done by either myself, my agent, servant or employee. •
BY
Contractor's
License No.
AUTHORITY
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
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 regula-
tions 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 buil ing during progress of the work.
Owner's Name and Address (, 4
Registered Architect and /or Engineer_______
Name and address of licensed contractor
Location and legal description of lot to be built o
Block__
Street and Number where work is to be done
State work to be done and p rpose pf building
?t� >a – .
New Building
To be constructed of
Estimated Total cost of improvements $
Zone cubage required____
appeared
and who, being by me first duly
of the above described co stru
therein by him s ted . re rti
Permit No.__
Disapproved
(Signed) _
Member
Council Approved_
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Remodeling
Kind o
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 referent
be sent to
The undersigned applicant for this building permit does hereby certify that be unde
of labor under the Florida Workmen's Compensation Act, being Section 5966, Comp
and has complied with the provisions thereof, and will require similar compliance fro
in the work to be performed under this permit; and will post or cause to be posted fo
or notices as are required by the Act. The undersigned agrees to employ only such su
permit, as are licensed by Miami Shores Village.
Remarks
, p
rfi
Building Inspector
y floors)
Subdivision 1 .���
Addition
foundati n
______Amount of Permit
Plan Cubage
r
Date_
r
Street_____________________
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized administer
Member
Date Disapproved
I
PLANNING BO RD DATE
Chairman Member
Member Member
ccepts his obligations as an employer
ws of Florida, Permanent Supplement,
ors or sub - contractors employed by him
on the site of the work such public notice
ors, op work to be perfofined under this
oaths
and take
rn, upon oath de••ses a N says thl he is the
that he has caref lly re ed the fojegoing application, and that he did sign the same, and that all facts
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission
19 �L : 'ii
_and for no other purpose.
No. of Stories
e building and its construction may
acknowledgments, personally
to me well known,
__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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Disapproved .__
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement (it the plans and specifications herewith submitted for the build
in 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.
Owner's Name and Address A rive Z..Q.r YfG11
Registered Architect and /or Engineer.. Do v L Iv EA ,.,. .....• <•,,.,,,..
Name and address of licensed contractor , r tL n e-L/ 64,9 - Q10 CA./ r c
Location and legal description of lot to be built on:
Lot. 3 § e l Block 9 / Subdivision / 141 ° 111 ' 'S
Street and Number where work is to be done 4 l° /VE z. _
State work o be done and purpose of building (by floors) lL.E.t .lam .....s!Lr
_.._. and for no other purpose.
New Building Remodeling ✓ Addition ✓ Repairs No. of Stories
To be constructed of Ce.S Kind of foundation ,{ Roof pvering
Estimated Total cost of improvements $ / � ✓ 075 ":' Amount of Permit $.... t U ( V
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Building Inspector
Date
— No..... .._... Street—iP Z 57"
.2 C ..
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 budding 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 Honda Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Pennanrnt Supplement,
and has complied ssith 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 inspection on the site of the work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such subcontract; s, on w ork to be perf:rmed wide y this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLOFIDA,
COUNTY OF DADE. ss.
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, rind that all facts
therein by him stated are true. �'( q
Permit No P D � Date /4) ° ��f hi l 1 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Merr.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 ha been obtained from
the PI.,nnir.;; Ito.rrd.
A re inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for in Lion or faulty
materials and /or workmanship.