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BUILDING PERMIT05CA2_ MSAMII S APPLICATI r ' "-td,gel-t-Ot4_7 Registered Architect and/or Engineer...--. --1 �!L.L� c1/ / r UJ� Name and address of licensed contractor Owner's Name and Address State work to be done and purpose of building (by floors) STATE OF FLORIDA, COUNTY OF DADE. ss. VRLLA E BUILDING INSPECTION DEPARTMENT N FOR BUIC®INIG PE 1' MIT 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. :std 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 pions and specifications must be kept at building during progress of the work. Date. Location and legal description of lot to be built on: Lot Block / Subdivision O ' { � /1/ 'YL Street and Number where work is to be done and for no other purpose. New Building Remodeling Addition . Repairs No. of Stories To be constructed of Kind of foundation Roof Covering op U Estimated Total cost of improvements $ D O x - -_�. Amount of Permit $_. Zone cubage required plan Cubage Distance to next u earest building Size of Building Lot Maximum live tat:-1 to be borne by each floor I hereby emu:.::.: all tue plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersi_ -.,.d applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under tr. Florid.: Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Per:nanent 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 pe :formed 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. Remarks ( Signed) i9 `,^1. ��� ��1`t\• Before me, Inc 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 135 Date 101 Read, Sworn to and Subscribed before me. Disapproved ,\_ - -__ _ ._ Date (Signed) .-V I1._tYX_ -!mot 3ut mg I spector My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Cl. -. Member Mort ..; r - - - - - - - Member Mern:,er Member Council ?.. >ed - Date Disapproved _Date NO' -- ci..rge o: $1.00 will be made for making corrections or changes to this application after approval has been obtained from =. c- i:.,;r eti ::: fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials ar.c: /or workmanship. • MOAM8 SHORES 'VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING 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. Owner's Name and Address 1e Street and Number where work is to be done State work to be done and purpose of building (by floors) ictit Date 30 ' No Ai Street L{tipLlL{/L^ 4 Registered Architect and /or Engineer Name and address of licensed contractor - - �Lt71"l� r ' Location and legal description of lot to be built on: Lot Block l / f✓ / ./� V v tP 'vision' A_k- r-Q9 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 Size of Building Lot Distance to next nearest building Maximum live lo..d 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 ::s 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 rcy sired 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. Remarks ( Signed ) _ _ �, -S'`c 81 STATE OF FLORIDA, COUNTY OF DADE. ss. Before rue, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persortally 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 Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member .... Member Council ?pprcve.;a Date Disapproved Date NOTE: :\ e; Vie of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Pl.uinii.g A re-in,; , -tion fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or we;rkieauship.