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864 NE 91 Terr (12)MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Applicat.on is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing of other stru ture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Vrlhag ^, F orida, 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 Miam Shores Village sh 11 be complied with whether her in specified er not. A cope of approv d plans and specifications must he kept at bwlding during progress of the work. Date Ma y 27 1966 Alverta H. Ehart 864 NE 91 Terr. Owner s Name and Address ___ _ _ No. Registered Architect and /or Engineer State worktto be • d do one and purpose of building (by floors) 27 274. New Building To be constructed of Remodeling _ Addition Kind of foundation Repairs Street_ I t 1 ,19. Name and address of licensed contractor _ __ Orkin Exterminating Co., -_ Inc., _ 1960 N. W . 27th Ave., Miami , Fla. Location and legal description of lot to be built on: Lot _ _ Block - __ _._ . _ __ Subdivision_ Street and Number where work is to be done_ ____ _ 64 N. E. 9 1 Terre ,_ Miami Shores , Florida Nylon Tent Fumigation Vikane, 18 to 24 hours, and for no other purpose. No. of Stories ._ Roof Covering ._ . Estimated Total cost of improvements $ ___ _ _ _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 the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this j iff DO¢ permit, as are licensed by Miau ii Shores Village. 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 foregoing application, and that he did sign the same, and that all fact therein by him stated are true. / �O P Permit No. __ - _=� /__ Disapproved (Signed) Date_ _ _ Date 7 .-- 1 . \_ Building Inspector /1 PLANNING BOARD Chairman - Member Member _ Council Approved NOTE: A charge of $1.00 will be made for the Planning Board. A re- inspection fee of $1.00 will be charged materials and /or workmanship. Member Member Member __ _ Date Disapproved _ `? `� Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires __ DATE to me well known, __Date making corrections or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection or faulty MI '>,MI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION F, 'R UOLDING 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. / a- Date Owner's Name and Address__ / /i No Registered Architect and /or Engineer Name and address of licensed contractor____ `E? D6 Location and legal description of lot to be built on: Lot Block Subdivision 1• permit, as are licensed by Miami Shores Village. Remarks (Signed) BuilcJifig Inspector 4 Street and Number where work is to be done State work to be done and purpose of Buildin (by floors ) / --3 L2 /°' co- 7 //s' Street 19 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 $ �� 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 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 m 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, ubcontractors, on work to be performed under this 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 I __ -0 1 Date / Read, Sworn to and Subscribed before me. Disapproved ( Signed) Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Boar A re -insp on fee of $1.00 will he charged when such re- inspection is made necessary by improper notice for inspection or faulty materials a or workmanship.