2876855 7 - J -t
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or ine 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. aiia_ 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 Feb.14,1989 ,19......_
Owner's Name and Address ...... Mr. ... Samue Battlman ... » »»»._. No...472 ....... Street...tr.-s: 98 St.
Registered Architect and /or Engineer , »,u• •••m •rrr.rrnmesntnr•m „,srerre.: :.
Name and address of licensed contractor
Loca io and legal desert ion of lot to be built on:
Lot
ii itr%✓
To r, ,_Rgp ing 133%5,•&L 1Q7 Ave. Jtia .eah Gard. 33016
Subdivision. y71 5i .! it /1 .1L.4 L / 90' 3
Street and Number where work is to be done 672 N. E.; St.
State work to be done and purpose of building (by floors). Reroof 2 Flat gravel roofs with 1 7laer
.... -of . 43# f i - l t • r - 2— layers-- •1.5#-- foltr• ad g r a v e l ,
»....and for no other purpose.
New Building Remodeling X Addition Repairs X No. of Stories 1
To be constructed of Kind of foundation:... ......... ».... .. Roof Covering Gravel
Estimated Total cost of improvements $ 3,885.00 Amount of Permit S...._30.00 .
Zone cubage required » ... _....Plan Cubage ... ». _._.
Distance .to next nearest building _._._._...Size of Building Lot ..._ -
m live load to be borne by each floor
I hereby submit all the plans and specifications for said building.
be sent to.. Tomco 13.0Qf ing713.39 5... ILL 101 .•.... 3015
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 the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractoron work to performed under this
pennit, as are licensed by Miami Shores Village.
Remarks (Signed
All
notices with
reference to the building and its construction may
STATE OF FLORIDA, .
COUNTY OF DADE. ss.
✓q s3
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared 'LPL. 4 i.g
._. to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the....Boafing...cont.taCtoi •..
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 are true..
Permit No.. t ffi .76x Date ° J//fff
Disapproved
(Signed
_ .._.. Date.
Building Inspector
Chairsnan
.\fcrr.bcr
Member .. ...
Council Approved
PLANNING
BOARD.
NOTE: A charge of S1.00 will be made for
the Planning 13o.rrd.
A re-inspection fee of $1.00 will be charged
materials and /or workmanship.
t
Read,
to and Su • scribed before me:
ublic, St / . lorida.�
My MtalfirliBt elF PL02IDS.». »» ......._ »..»._...�.
MY COMMISSION EXP. NAY 5, 1989
BOWES maa_Guahillgs. UND.
Member
Member
.... _ Member
Date Disapproved .. ».. »..» Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty