293 NE 100 StT
Registered Architect and /or Engineer ,e"
a r
be sent to
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Disapproved _________— _________ f __—__ Date
(Signed)
earn
Chairm
Member
Member
Council Approved
MIAMI SHORES VILLAGE
f
Date
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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 building during progress of the work.
G
f
4
Owner's Name and Address__rT t,� d____:____ _= �_ =_ _ No.__ - -__ Street —__
Name and address of licensed contractor____ '
Location and legal description of lot to be built on:
Lot...--_-_--.:- .__.c—_—__ Block___' __�_ Subdivision " ' 1—
Street and Number where work is to be done .', r a .a
• / • 1 y . —T
State work to be done and purpose of building (by floors) r fir, , m `
and for no other purpose.
New Building __________?r ___ - _________. Remodeling_ Adc _____ Repairs No. 1 of Stories „._______
/ .4, ✓
To be constructed of__ _ yr' Kind of foundation r,,.x,.�__ Covering " 1 .�-t Roof Coverin ` t
.�
Estimated Total cost of improvements $ _j_s - =¢.;t '' _Amount of Permit $
Zone cubage required _Plan Cubage
Distance to next nearest building_— Size of Building Lot ' ,--._ "�! 7 _,__ 7 _______ __— __— _______A_
Maximum live load to be borne by each floor_____ —__—
I he submit all the plans and specifications 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,
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. 1 1 ,,
Remarks (Signed) � _ f ' ^
x
1
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known,
and who, being by me first duly sworn, upon oath deppses and say/that he is the ________ -- ___
of the above described construt,ti , that he has care641ll zad the foregoing application, and that he did sign the same, and that all facts
therein by him stated are -tfrue/ I
Pe No
or
PLANNING BOARD
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection
materials and /or workmanship.
(over)
Date _4_= ' • -=J -- — — - 19!' !-
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
y Commission Expires
f DATE
Member
Member
Member
Date Disapproved
__._Date
or changes to this application after approval has been obtained from
is made necessary by improper notice for inspection or faulty
w
LIST OF CONTRACTORS, SUB - CONTRACTORS.' ETa
REQUIRING OCCUPATIONAL LICENSES ,
MIAMI SHORES VILLAGE
1. General Building Contractor. ���� O ®4"
4'
2. Plumbing, Heating, Ventilating, Air Conditio g and Gas Fitting. %
3. Electrical. --
4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators.
5. Excavating, grading, filling and Landscaping.
6. Moving or wrecking.
7. Septic Tank and Drain Field. w
8. Brick, Stone, Tile, Cement Block, Concrete and Gypsum.
9. Carpentry, Millwork, Awning and Shutters.
10. Cement, Lime, Plastering, Stucco, Lathing and Cast Stone.
11. Decorating (interior and exterior) , Painting, Waterproofing, Damp- Proofing and Paper- hanging.
12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring not otherwise
specified.
13. Ornamental Iron, Bronze and Steel, Steel
SJsh, O r b ead Doors.
a / eA
14. Roofing, Sheetmetal and Skylights.
15. Solar Water Systems.
16. Well drillers.
17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc.
18. Structural and Reinforcing Iron and Steel.
19. Tile, Terrazzo, Marble, Granite and Cut Stone.
20. Electric Fixtures.
21. Illuminated Signs.
22. Bridge, Bulk- heading, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga-
tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work.
23. Every person, firm, co- partnership, Corporation, Association or other organization engaged in the bus-
iness of supplying, furnishing or delivering building materials for any construction project within the
Village Limits and not having a regularly established and licensed place of business in the Village.