1022 NE 91 Terr (7)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or we plans and specifications herewith submitted for the build •
ine 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 iltiildiiig 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. ..—.. , 19. aQ
// op - c
Owner's Name and Address ...............11l. N. ._... ., eL Q . — No 1.1.. t.. Street Gt7. a>Si
Registered Architect and /or Engineer ..........4U... e ...... FA9e . rler -
Name and address of licensed contractor C ' Q en h / s
Location and legal description of lot to be built on: /aag J4Je- 9 76-,e ,41 sA.rir s ,C 2_ 33/38-
Lot Block Subdivision �
Street and Number where work is to be done 4 44. F_}St.._.., r!4 C' ,QQ.t "
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling 'Z. Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit S ...
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.. /te/ %n /49.d /.A.. /09...9 'V f/ 7 M _z
, .JA fes / _
The undersigr,cd applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor tinder the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied .p ith 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 ublic notice
or notices as arc required by the Act. The undersigned agrees to employ only such subcon• ctors, on work o be perform under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed).—
STATE OF F••LORiDA,
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, said that all facts
therein by him stated are true.
Permit No OX� tb Date q Read, Sworn to and Subscribed before me.
Disapproved Date Notary Public, State of Florida
(Signed)
Butlding Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Merr,bcr 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 I'Lrnnir,;; lto.trd.
A re ui.pection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspectiom or faulty
materials and /or workmanship.
Application is hereby wade for the approval of the detailed statement of the plans and specifications herewith submitted for the build -
::;g or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
S c.r s Village, Florida, and all provisions of the Laws cif the State of Florida, all ordinances of Miami Shores Village and all rules and
gu',atioas of the Budding Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
pans and specrications must be kept at building during progress of the work.
nr.:er•s Name and Address..
Registered Architect and /or L
gineer
Name and address cf licensed contractor.
ti
Dsapproved
(S :.;aed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR wLIILDING PERMIT ,..._
'Pvt./
Loeatioa and legal description of lot to be built on:
I_. :t 3 / - / ' 4 'r Z . Block / Subdivision
Set and Number where w ./ ork is to he done 00:
State work tgbe done / etnd purpose of building (by floors),
too— go
NZ
Date-
No.. ✓ v672 Street
(Signed)
ate
Notary Public, State of Florida
and for no other purpose.
New Building . ............. ... Remodeling ...._........ Addition Repairs ' No. of Stories •
To he constructed of ...- . Kind ofjoundation Roof Covering
._:::Hated Total cost of improvements $ e' Amount of • Permit $
Zc ::e eubage required flan Cubage
Distance to next nearest building Size of Building Lot
Maxi::um live load to be borne by each fluor
I hereby submit all the lans and specifications for s• id build g. notices with reference to the building and its construction may
h: sent to . . L�u'vrt�/JitRi '
'Fite undersigned applicant for this' building permit does hereby certify that he understands and accepts his obligations as an employer
r.[ i ;or under t :,c Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Snpplcnicnt,
!:.:s complied v.-ith the provisions ther and will require similar compliance from all contractors or sub - contractors employed by him
in the v:o :k 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 b the Act. The undersigned agrees to employ only such subcontractofs, on yyork to be perform ed un.4er/yhis
e: :::it, as are licensed by 'Miami Shores Village. -
STATE OF FLORIDA, )
COUNTY 0. DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
;e.red
to me well known,
and tvho, being by me first duly sworn, upon oath deposes and says that he is the.
o: tl.e above described construction, that he has carefully read the regoing application, and that he did sign the same, and that all facts
tr,t:ei. by him stayt:�ar�tru/ (�
Permit No Date.. worn to and Subscribed before me.
Building ' ector / My Eommiss'.. Expires
PLANNING . •ARD DATE"---
Cl. airr,an . -- / Member
lt;e :abet - . Member
Member
•
Ccu:,cil 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
tl•e ....n::, Board.
A re- i :.,peciicn fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
n.ateri..ls and/or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade for the approval of the detailed state:,ucnr oe 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, Ilnrid.e, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the iuilding Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
pl,uts and specifications must bc kept at building during prag s of tthe (- �J
' ate. _ _ � 1 ! .�
a crfl ®N.. ` 1 1...b -• i ..4 .1. .. Street Owner's Name and Address ,. L�_ No. r..._. r
Registered Architect and /or Engineer ELA g is 4 ,., y° '!�-` .. 4 „�'� r- . � . ��' e •
3/ �
Name and address of licensed contractor _.— 3
Location and legal description of lot to be built on:
Lot Block Subcyision
Street and Number where work is to be done 1.0'%' i I ll ...._.. .-
State work to be done and pure se of budding (by floors) ...ti.!. .1A _ 0 11'V `' S '
- ... V V1.N* SPA ° (SMarta ..69) )
__._. and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ .0 Amount of Permit S. 1,0110
_
Zone cubage required .Play Cubage
Distance to next nearest building.. Sins 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 under .;coed 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 59G6, Compiled General Laws of Florida, Permenent 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 arc required by the Act. The undersigned agrees to employ only such ubcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. .� 1 I 1
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. ._..!� 1 1/6 Date 1 +) Z5) 1 19 - Read, Sworn to and Subscribed before me.
Disapproved.... Date Notary Public, State of Florida
Lidding Inspector My Commission Expires
..................
PLANNING BOARD DATE
Chairman Member
Member Mcmbcr
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 i'Li.nnir. lio.erd.
A re•rn't)cctiun fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty
materials and /or workmanship.
git 41 ERR.