901 NE 91 Terr (12)peared
Disapproved
(Signed)
/ dX 4 Re 64
MIAMI SHORES VILLAGE
Building Inspector
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Applierdion is hereby umdc for the approval of the detailed statement of the plans and specifications herewith submitted for
ins or other structure Herein described. This application Is made in compliance and conformity with the Building Ordinance
Shores Village. hle;ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all
regulations of the building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of
plans and specifications must be kept at budding during progress of the work.
Owner's lame and Address . 1 • • a k ' (G I(1- No c 1 ... Street ' . ...4 .�:
Registered Architect and /or Engineer .. � ' N(� G _ LAG
Name and address of licensed contactor NGt1 `f} CCP1Sj1?(:C1OI3 CO(
Location and legal description of lot to be built on: Ali- U I-GT It C"GE-0• 1 -42jN
Lot block Subdivision ‘..: Q� U L _
Street and Number where work is to be done C IO 1 14,a . T i TEc2
State work to be done and purpose of budding (by floors) col-Next C..jh':.,. t- - oj�_ 602d E_- 'ic ?Ilt
may? ( - L rx.tTa2 'Room,
New Building Remodeling Addition Repairs
To be constructed of C- 6. Kind of foundation 61
Estimated Total cost of improvements $ 9 sS o O
Zone cubage required
Distance to next nearest building
Maximum live load w 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.. . ....... UCA)(r C'slncDTV4 Cdt Uv � C i f L.E � IS \Vl .? � (:1 /4 . N.t4,lj . 3.3icoi .
The un ^rsicncd applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under t. :e Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
..nu has complied s nth 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 subcontractors, on ork to be performed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks (Signed)
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-
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 sage, and that all facts
therein by him �� n. stated are true. 1/.44k
Permit No -!v Date Read, Sworn to
PLANNING BOARD
Cnatnnan
Nleniber
Member
Council Approved
Date
Date.. - _
and for no other purpose.
No. of Stories tI
oof Coovering. 1�1..S es" t2r — . IP L.e
Amount of Permit s....1 /NV
-Plan Cubage
q .
Size of Building Lot ....t p �5t'2.. . 13 l -7 ... .
DATE
the build -
of Miami
rules and
approved
otary Public, State of Florida
My Commission Expires Notary Public, State of Florida at Large
My Commission Expires Fesivary'29 't96i
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 been obtained from
the I'Luuur l:uerd.
A re ,n.pectiun fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection cc faulty
materials and /or workmanship.
PLANNING BOARD AGENDA OF JU� g/1 1C ITEM NO. 3
NiaNik Qo Nvr. coup. �� o�
N. nie of Owner /Applicant KI��tR1� 9 Di��1C -14 Phone No. '1 '`` ' O� o 1 1 4 5 1
Address of Property, and /or Legal Description9o) 14S. 91 - TERM,
Nature of Request APPROV tl. n-10 tOttb. efahCM
Present Zoning it \.o4 J
r
Area of Present Building
Area with Proposed Addition
Parking Spaces Provided
Parking Spaces Required with Addition
Setbacks as per Code
Setbacks Provided
Variances /Exceptions /Zoning Change
Council Action Required
Date of Applicant Notification
Planning Board Action .''IS
Council Action
aiami cJhores91llage
F L O R 1 D A
Director of Building and Zoning