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860 NE 91 Terr (8)Application is hereby made for the approyal 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 Architect and /or Engineer Name and address of licensed contractor r Location and legal description of lot to be built on: Lot Block Subdivision ._ ... - Street and Number where work is to be done 7 r�2t s5___t___ -9 State work to be done and purpos - of buildi (b 7, rs ). Disapproved (Signed) APPLICATION FOR BUILDING PERMIT Date BUILDING INSPECTION DEPARTMENT Building Inspector MIAMI SHORES VILLAGE ad, Sworn to and Subscribed before me. Notary Public, State of Florida 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 $ 9 - - 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 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 pennit 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 t e.• k such plie notice or notices as are required by the Act. The undersigned agrees to employ only s .contractors, ,.n , tg p\ forme.,nder this permit, as are licensed by Miami Shores Village. Remarks STATE OF FLORIDA, COUNTY OF DADE. j 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 C ate f ---'My Commission Expires PLANN G BOARD DATE Chairman � Member Member 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 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. Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor �z1 Location and legal description of lot to be built on: Lot Block Subdivision_ Street and Number where work is to be done Chairman Member Member _ State York ty be done nd pu se of building (by floors) New Building Remodeling clX Building Inspector MIAMI ` SHORES VILLAGE APPLICATION FOR BUILDING PERMIT BUILDING INSPECTION DEPARTMENT 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. y Date Disapproved Date ( Signed) PLANNING BOARD 'A My Co Addition No & (A,1IYAtreet____ o !!_a__Lr? f_ /' 9_L_L__ r: 1_117 O Repairs y Public sion Expire o and Subscribed and for no other No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ c4 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 subm't ll the plans anddss f}catidns for -said building. All notices with reference to the buildin ° : nd its construction may - be sent to � ' ( L!d_ / ✓ / 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 uch public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on w . k to be . • brmed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed ) __ - r se. STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary p lie, duly horize 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. uoa _SIRS/t L C€6 dl " 3fa DATE 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 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.