1236 NE 93 St (4)Registered Architect and /o
MIAMI 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.. /1
Name and address of licenseded- o- ctor.SS4 Yc -Z AM) 26 SY
Location and lega description of lot to be built on:
Lot_4 e ZS Block Z Subdivision i AyL ed ae E
AA E 4°3
) J
State. work to be done and purpose of building (by floors)___fi.T A .__._. . I/4�9 u �_..... . l.Q. .0.1 11
•..... a . n_.s E x.t. "T. Res
Street and Number where work is to be done ...... 6
CAg. DA 1412._
and for no other purpose.
Date
si i9a
No /& 3 G Street. Ai E 7 S
New Building Remodeling Addition V Repairs J)
To be constructed of_.__ l . .. Kind of foundation Roof Covering 114 4111
Estimated Total cost of improvements $
4 Amount of Permit $ 2 - S¢5
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum 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 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 subcontractors, on ork to be pe ormed under this
permit, as are licensed by Miami Shores Village. �
Remarks ( Signed) (,® `
No. of Stories
STATE OF FLORIDA, I
COUNTY OF DADE. ss
Before me, the 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 hire stated ire true.
Permit No
Disapproved Dat
(Signed) ...
Date.__ 3 ✓ 6 / Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Bu lding Inspector - My Commission Expires
PLANNING BOARD DATE
Chainnan 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.
v�
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 $to of Florida all rdi awes .f Miami Shores Village and all rules and
regulations of the Building Division of Miami S res Village sha)1ie complied awes with, w ether 11 - ein specified or not. A ccpy of approved
plans and specifications must be kept at builds during progre th 'v c. D , 4
�/ Date ., , 19.fP./
Owner's Name and,Ad & -ie 9 2 r/1 e- L 't No /a 3 6 Street A" 9� sr"
it Regis red Architect aor ngineer 6' /9 /R 1>' ,L L.
J�7- it -
I6h4 n /
nd aAr�W 4f ' 'd contract9r._5 4 y 1 S° 44 Z�?C3_ ._- 97 /P/IV 2,' Sr ___ -
Location and legal de of lot to be bui t on: /J
Lot_.t e .e- / CA" Block Subdivisiorr4.
Street and Number where work is to be don
yied 04 3 + 1
New lading Remodeling
'Tr/$bnstructe1 0L..../A-14 I._ Kind .f foundation
Estimated Tot �ry3 p5 improvements $ /45.
Zone cubage required
Distance to next nearest building
Maximum live load to be borne by each flo
The undersigned applicant for this buil
of labor under the Florida Workmen's Con
and has complied with the rovisions there
in the work to be performed under this per
or notices as are required by the Act. The u
permit, as are licensed by Miami Shores
Remarks
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BiUILDIN I3 PERMIT
Chainnan .....
Member
Member ..
Council Approved Date
iZ3_6
" g rk to e�one p rpose of build g (by floors) ___.4_
Inoum. - u ,r,ylit $
and for no other purpose.
No ofSt
Roof .vering I7._.L ell
Plan Cubage
Size of Building Lot
I hereby submit all the plans and specif cations for said building. All notices with reference to t e building and its construction may
be sent to
ing permit does hereby certify that he understands and a
ensation Act, being Section 5966, Compiled General La
f, and will require similar compliance from all contractor
lit; and will post or cause to be posted for inspection on t
dersigned agrees to employ only such subcontractors, o
age.
'notary public, duly authorized to administer oaths and take acknowledgment!, personally ap-
Before me, the undersigned authority
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
(Signed)
Notary Public, State of Florida
PLANNING BOARD DATE
cepts his obligations as an employer
s of Florida, Pennamrnt Supplement,
or sub - contractors employed by him
e site of the work such public notice
work to be per ormed under this
My Commission Expires
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 Planning Board.
A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
w‘am.