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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.