878 NE 91 TerrApplication 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.
1
Owner's Name and Address_:
Registered Architect and /or Engineer_
Name and address of licensed con. f or
New Building Remodeling
To be constructed of via. S. Kind of foundatio
Estimated Total cost of improvements $ 1 7. 2444) _
Zone cubage required 1 G i�L�
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Permit No
Chairman _
Member
Member
Council Approved
-/ , e
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date
Date
Distance to next nearest building _Size of Building Lot
Disapproved - Date
( Signed) �._.
• Building Inspector
PLANNING BOARD
No k p / Street__.
1
h- C f
M / ,
• 4,
, 19
Location and legal description of lot to be built on:
Lott/ 2 _ _ 3 Block Subdivision__ _ a a - cLe' ti � p .' .
v
Street and Number where work is to be done__ � __ T T
__ I � " _ ' - 71, ' I ` —5 7
State work to be done and purpose of building (by floors) lam/ .�.L f , ('
and for no other purpose.
Addition Repairs No. of Stories f'•K._
__ ___ _ Roof Covering
1, 4
Amount of Permit $ _
JU _Plan Cubage___1 -
Maximum live load to be borne by each floor to
I hei+eby su mi 11 the plans and specifications for said b • ing. All notices with reference to the building and its construction may,
be sent to 1(9' f !1_, / , —�[
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 rovisions 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 subcontr ors, on work to be performed tinder this
permit, as are licensed by Miami Shores Village.
Remarks____ r (Signed) .:! _ _ / �`�
Before me, the undersigned author' , otary public, duly authorized to administer Baths 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 b'J'ti rr a'iR are true. -
1� 1
78
7J x 5
Reid, Sw i/ o and Subscribed befo
Notary blic, State of Florid
Notary Po _, We !! eh �f
My Commissio 'Expires M eom iss -- exfdrot _a440asy__4 J
B•nded by'Americaq. Surety (o. o4 Y;
Member
Member
Member
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.
fr6