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1050 NE 91 Terr (6)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. Owner's Name and Address A Registered Architect and /or Engineer Street and Number where work is to be done L permit, as are t licensed b Mi ami ores ' Sh Village. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT l c _ Name and address of licensed contractor.... _ ��-L- -9 - -L - A o t Rte. • Loc and legal description of lot to be built on: Block Subdivision t e State work to be done and purpose of building (by floors) sE and for no other purpose. New Building ■ Remodeling ,addition Repairs No. of Stories . To be constructed of _4 :A2:A_ Kind of foundation __ �.X_..p' o . S_1 .6 Roof Covering _Cc...;, �; ,. Estimated Total cost of improvements $.�_. , 7 Amount of Permit $ Zone cubage required Plan Cubage7E} TL. 41 G p 0 Distance to next nearest building Size of Building Lot ,1 L" .0 14 Maximum live load to be borne by each floor I herebyibmit all the plans and specifica for said building. All notices with reference to the building and its_ construction may r -n The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer Florida, of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of and has complied with the provisions thereof, and vvill require similar compliance from all contractors or Permanent SuPplement, him ntsctors employed by hi 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 Date Disapproved Date � S 0 , 19 SO ! L�-._ Street !� 0 e r. to me well known, and who, being by me first duly sworn, upon oath d .ores and says that he is the of the above described construction, that he has car ully read the`foregoing application, and that he did sign the same, and that all facts therein by him stated are true. �+ Permit No l Y Z l 1 Date - Z3 - `3 a /�V Read, Sworn to and Subscribed before me. Disapproved (Signed) .. Notary Public, State of Florida Building I pector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved 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 Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 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. Owner's Name and Address. Registered Architect and /or Engineer._. 4P 1 Name and address of licensed contractor /ilernmi Location and le 71 criptifln of lot to be built on: Lot ��� 0 r 9 Block Subdivision Street and Number where work is to be done � 1-Q State work to be done and purpose of building (by floors) 11 d.d 451'I/V. and for no other purpose. New Building ,I}emod I dditio Repairs No. of Stories To be constructed of qilfe'l '4`'Ar..Kind of lion t it 'd- C reiN Roof Covering Estimated Total cost of improvements $ 7400 6 Amount of Permit $ 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 p ns Ind s ecifications for said building. All notices with reference to the building and its construction may be sent to /*Maid 1 06 /6 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 su ntractors, on work to be performed under this permit, as are licensed by Miami Shores Village. a 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 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 for _oing application, and that he did sign the same, and that all facts therein by Permit No Disapproved (Signed) are e. BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Date.. e�v4 7- MRS PCA MIAMI SHORES VILLAGE Date Date. Council Approved i� a — O 'CS c 7 Yt /V, A. � .O 9/ Date recem. NoJ' Street l� �® to me well known, Read, Sworn to and Subscribed before me. Notary Public, State of Florida ,19` 7 VK Building Inspect. My Commission Expires ANNING BOARD DATE Chairman ! Member Member Member Member Member Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has heen obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.