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1051 NE 93 St (4)Gt.7r1e7 Name and Address L,czi,tered A;-eh_tect and /or Engineer I`NTarne. and cdri: -.ess oz licensed contractor.. 00 6 '6•'' , 122 STATE OF FLORIDA, COUNTY OF DADE. ` / Application is hereby made for the approval of the detailed statement of the plans and specifications herezeth s•.i e s,itted for the build - ing or other structu; :e herein described. This application is made in compliance and conformity with tree a dL :- Ordinance of Mac ' Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Vis ^ age and ail rules and regcnP:ations 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. Date__ �i ? >, / ✓l% / �" r No. _ / _Li Street Location and legal description of lot to be built on: Lo - Block Subdivision_.. - Su-eet end Number where work is to be done % State viork to be done and purpose of building (by floors)__ - ___ _ is _�� li(l 'ire f % �U � and for no other purpose. New Building Remodeling __ -- Addition -- - -- -- - --- -- - - _. _ Repairs.. No. of Stories is constrccted of Kind of foundation_..._ . ___ -_ . Roof Covering._ _ Estimated Total cost of improvements -.__ Amount of Permit $.._ - - -. Zara cubage required .Plan Cubage_ - -_ -- _- - i .1fstc_a tc rent nearest building Size of Building Lot Zi.animu_:n 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 a`_s obi.getions 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 rer;uire similar compliance from an 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 ar notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to o< performed under this permit, as are licensed by Miami Shores Village. ?3.emaz'_cs - - -- - - 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by hire stated are true. �' c 2 Peararst No. . `� � Date_ Disapproved Date.__. __ _ (' ( Sigced) -`-> Bu_Iding Inspector �/ My Commissio:a Expires__ Read, Sworn to and Subscribed before me. Notary Public, State of Florida 2 to me well known, PLANN'I BOARD _ ______ . -- .DATE Chairman // -. - -- Member Member - . Member Member ._ Member Council Approved __.__.__ __ _ Date Disapproved Date NOTE: A charge of $1., 10 will be made for making co •rec ions or changes :o this application after approN al has been obtained from the Planning Board. A re- inspection fee of 81.00 will be chargad when s. , h re- .n:pection is made necessary by improper not ce for insp:• tion or faulty materials and /or workmanship. BUILDONG INSPECTION DEPARTMENT AP LBCATIION FOR BUILDING P RMET Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted far the build- ing or other structure Inrein 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. MA Date Ck. Name and Address.. 5 i'4A No. ia J Street ResLtered Architect and/or Engineer Name and address of licensed contractor_ . 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 and purpose of building (by floors) :4 New Building Remodeling Addition To be constructed of Kind of foundation_ , - o Estimated Total cost of improvements $ .q5" 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___ hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may be sent to__ The undersigned applicant for this building permit doc hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen s Compensation Act, being Sec:ion 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 permit, as are licensed by Miami Shores Village. AP 7 , , f, Re:narks ( Signed )___.2/ STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, di :-.• undersigned authority, a notary public, duly authorized to administer oaths and take ackaowledgments, 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 Date Read, Sworn to and Subscribed before me. Disapproved 4: Date (Signed) - // Chjinan Member Member . Council Approved PLANNI BOARD_ NOTE: A charge of $1.00 will be made for making the Planning Board. A re-inspection fee of $1.00 will be charged materials and/or workmanship. HE:114ES VILLA Subdivision. _Date Building Inspector My Commission Expires__ oof Covering._ Notary Public, State of Florida DATE Member Member Member Disapproved and for no other purpose. Repairs No. of Stories Date 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 •