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1050 NE 91 Terr (5)Owner's Name and Address •�' Registered Architect and /or Engineer. Name and address of licensed contractor STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE Building Inspector Date BUILDING INSPECTION DEPARTMENT. APPLICATION FOR n UILD NG 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. Date q45./4- Chairman Member Member Member Member ...... Member )�ate..._..� � _.... =��. .m..._...__._..._._..,...._... , Ili.:._..'' Read, PLANNING BOARD 7.5 _.. Street...._ ftt••ttte ••f,lAf!••N!•!•Sf! ttt! t ^!t!!!.. Location and gal description of lot to be built on: Lott* /l� �� ' . �... � mil.._. 6' � � ! Block A, Subdivision... G� . .._.. ...__. .. ..._.. � � Street and Number where work is to be done //-"/ Y. , - -.. / ./e e' ••...._ State work to be done and purpose of building (by floors) L'!�;' , 7 ._,.::...° ✓ __. 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 $ 060 Amount of Permit S.. c" . °+ lone 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 theFlorida 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 performs under this permit; and will post or cause to be posted for inspection on the site of the work such ublic.not4ee� or notices as are required by the Act. The undersigned agrees to employ only such subcontractors work to be perform nder —tkus permit, as are licensed by Miami Shores Village. Subscribed befo a B Remarks..._ (Signed) Before me, the undersigned authority, a oeasy public, duly authorized to administer oaths and take acknowledgments, personally ap- peared . 6 • PO 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.._Z:P _ Disapproved (Signed) Notary Public, State of Florida My Commission Expires NOTARY PUBLIC STATE OF FLOaIDA MY COTAT'JlSSiO 12XPf,,73 ,71 3' 7176' DATE CO\9cD . Uo‘oc.,0,J,c1 TERS • Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections oa changes to this application after appmral has been obtained from the Planning Board. A re-inspection fee of 51.00 will he charged when such ea- inspection in mach Qt scary Iby itnizwapev =Use fog €nspevtinn � faulty materials anu /or workmanship. MiAW H[r—i.L3RELI VOLLAUE ..ElUILDENG ONSPECTION DEPARTMENT AFFili2ATION FUR LHLEDONO Application is hereby made for the approval of the detailed stattoienr ni Inc plans and specifications here ith submitted n37 the build in or other structure herein described. This application is made in compliance and conformity with the Buildinrf, 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 SECiflIC'd c1.02. cloy cpprovca2 plans and specifications ntust be kept a building during progfC43 of the worlt. Date --0/2W.g Owner's Name and Address Sanders No St'c'ea— Registered Architect and/or Engineer ........... 1050 11 E 91 Terr AA VA M .. TACA SOUTHERN FUMIGATORS, INC 50 S 6th.. St Ft IRANI__ Namo and adaress of licensed contrectoe 39 Location and legal description of lot to be built on: 945=2052 Lot Block Subdivision Stseet cnd Number where work is to be. dono Estimated Total cost of improvements $ Zone cubage required Distance to ncnt nearest building. Ma live load to be,,borne by each floor Disapproved Date. (Signed) Chairman ferfibtr Member Council Approved Date 105 N. E0_91 Terr Sento v'or o bo clone and purpose of building (by floors) — FUMIGATION appr 51 Cubes mel for no other purpec.:2. New Building Remodeling Addition Repairs No. c Stories _ A To be constructed ,of Kind of foundation ne:Dg 0:WC:fig/Li, $500.00 Appr Amount of Permit $. $7,00 _Plan Cubage , Size of Building Lot ............. . .-... ..... - I hereby submit all the plans and spccification 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 of labur under the Florida Workmen's Compensation Act, being Section 5966, C and has complied with the provisions thereof, and will require similar comp in the work to bc performed under this permit; and will post or cause to or notices as arc required by the Act. The undersigned agrees to employ permit, as are licensed by Nliami Shores Village. Remarks (Sig PLANNING BOAR* DATE o• understands and accepts his obligations .i an vinployc7 led General Laws of Florida, Permanent Supulement, all atractors or sub-contractors employed by him ction ern the site of the work such public notice. 2:s•ceo oo VIZY'Ll (33 b cocmd under taiD STATE OF FLORIDA, BOUNTY OF DADE. ss. Before' me, the undersigned authority, a notary public, duly authorized to administer oaths and eche 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 MSTC:."., rd On2 CI! k3 therein by him stated are true. Permit ......... Date Read, Sworn to and Subscribed before rne. Notary Public, State of Florida Building Inspector My Commission Enpires Member Member Member Disapproved NOTE: A charge of $1.00 will be made for making corrections or changes (to hla application after cppxxr] NC:3 the Iluard. A re Ice of S1,00 will be charged when such - tncpcctIo hi caoeo RasQacnry by trtsms-57,.27 ezzvm c-2 ffr.n:2 materials anci/or workmanship.