560 NE 102 St (12).,F(IIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT.
t
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the 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 Miaml
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.
f Date..._........ »� �.._._ p ,19..24
Owner's Name and Address ..... r �.. z. b F4`tC,�� ;j..� _ No..,� � Street-4/4. 1 (...._.
Registered Architect and /or Engineer __ , ++ __ ___ _ _
Name and address of licensed contractor .. i'-_ . Lt[ -' ) C l
Location and legal description of lot to be built t on: V
Lot Block q Subdivision
Street and Number where work is to be done
State work to be done and purpose of building ( ") _..._
_ - /..'EL"..d.'.- - .......'�...�. NZ_ / I .Fe ra..C: , -
and for no other purpose.
New 1. ng ✓ Remodeling Addition Repairs . No. of Stories
To be constructed of .... JL. Kind of foundation -i` - Tiering
Estimated Total cost of improvements $4f Cos? ' Amount of Permit $.
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 with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performe 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 are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Disapproved r t ?.... Date..
(Signed)
-
Chairman
Jfcrnbcr
Member ...... — - -- _....._
Council Approved Date
Remarks (Signed)
Pleaded
1 I C %; . .,
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 true.
Permit No. Date Read, Sworn to and Subscribed before me.
to me well known,
Notary Public, State of Florida
Building Inspector My Commission Expires
PLA BOARD DATE
Member
Member
Member -.....
Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has
the Planning hoard.
A re-inspection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for
materials and /or workmanship.
been obtained from
inspection or faulty
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According to the Plat thereof
es recorded in Plat Book 15, at
Pale lk of the Publie Records of
Dodo Conobg, Florida.
W.r PlEILERY CERTIFY THAT TH.'7 ;1. 4.`,/
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123.03-94
BUILDING & ZONING - ADMINISTRATION
•
PLOT PLAN
•
so
Legal: Lot No. Block No.
Subdivision 47en Id Ptaro f SEC. TWP. RGE
or f)i •tt3
Metes & Bounds
NOTE: 1. Show existing buildings and additions.
2. Show distance from property lines to buildings and /or new additions.
3. Locate septic tank or sewer and electrical service.
NO SCALE
Plat book and Page No )5 /I
560 Ne, /o
nYt ate, .k s IND s
TV't 413
TERR., AVE., CT., PL.
NORTH ARROW
r
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the 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.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor__t..
Location and legal description of lot to be built on:
MIAMI SHORES VoLLAGE
BUILDING INSPECTION DEPARTMENT
1'
Lot Block
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
New Building Remodeling.
To be constructed of Kind of foundation
e - -.. , 19 ,
No $freer_
Subdivision
2 0 .4.24 46/2/2-0-exo-azeL"ee_,>----
and for no other purpose.
Addition Repairs No. o St
Roof Covering / /
I hereby ubm' 11 - plans . • speci 'cations for said building. � Allt s not ti ices / 6�
wit ference to the building and its constr�tion may
be sent to - L! r •i! �s �G� 5 _ 21
4/ • , /d^ b —a . 72 �Glr..' 1 , 1 /
717D�
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
The undersigned • plic /t for th s 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 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 are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)._
STATE OF FLORIDA,
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, and that all facts
therein by him stated are true.
Permit No ( Date / Read, Sworn to and Subscribed before me.
Disapproved � Date._
(Signed) ._ ......
Building InspecQ My Commission Expires
NING BOARD DATE
Chairman Member
Member 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 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.
Notary Public, State of Florida