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897 NE 91 Terr (6)— f1- — ?r - a AR 50 ° k ° I6" 444 e ‘ 5 33 O 4. a 90 � e 3 , C 6,,,„ --�i_= w a �e8- �: p - 7.-T 206 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 wq 6 .cd / Date ' / 9 , 19 f Owner's Name and Address �/ � " � No ��''J1 /se. Street__ . _�✓� � Registered Architect and /or Engineer .L Name and address of licensed contractor___ A Y -2 Location and legal description of lot to be built on: Lot__ Block Street and Number where work is to be done State work to be done Remarks (Signed Permit No Disapproved ( Signed) era" Aka, 7° • MIAMI SH © RES VILLAGE BUILDING INSPECTION DEPARTMENT v� APPLICATION FOR BUILDING PERMI i 7/�' /,"4 & &1 = 2,70 � Subdivision_._ etZ and purpose of building (by floors)_____a_t, • ? (1 x'6''7" Addition Repairs No. of Stories___ / /'F/4 6 New Building 1 Remodeling To be constructed of , A Kind of foundation Estimated Total cost of improvements $ / ' J' 7 Amount of Permit $ Zone cubage required__ __ / Saa __ flan Cubage s Distance to next nearest building Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference be sent to and for no other purpose. Size of Building Lot RooCovering ___ (1.11.2_2__7 _ ' If to the building and its construction may 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 subco i tractors, on work o be under this permit, as are licensed by Miami Shores Village. Read, Sworn to and Subscribed before me. / 7/ 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 =!/' 4N to me well known, and who, being by me first duly sworn, u on oath deposes and says that he is the of the above desMbed_construction, that ) e has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are, true. akin 1c1 L� _1 Date Y (AO • (� Building Inspecto 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 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.