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302 NE 92 St (7)New Building Remodeling To be constructed of__ Kind of foundation_ Estimated Total cost of improvements $ Zone cubage required— 2 a a cb Distance to next nearest building STATE OF FLORIDA, } COUNTY OF DADE. Chairman Member Member Council Approved_ Date NOTE: A charge of $1.00 will be made the Planning Board. A re- inspection fee of $1 materials and /or workmanship. PLANNING BOARD 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 building 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 regula- tions 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. Addition__ Date__ Location and legal description of lot to be bu'lt on: k a Lot...../4_. 1 = Block__ ____ Subdivision F- I Street and Number where work is to be done 3 _0 - 4" Z State work t be d and purpose of ilding (by floors) 4 Owner's Name and Address Registered Architect and /or Engineer IV A L - L __ �__ � f 12 41......1(42 LJ ' Name and address of licensed contractor fl v/40 / y ' 9 Ll / - - --a , 19 ( / No. __I�� $ Street M 1 fi�rr ! 4_ —! _and for no other purpose. epairs No. of tories____/ ! _ Roof Covering____ _Amount of Permit $ __Plan Cubage__ _________ Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said . • ing. All notices with reference t the building and its construction may be sent to 7a — "e �i. ® G .9 , r di LaN The undersigned applicant '' 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 subcontracto • , on work be performed/Qnder this permit, as are licensed by Miami Shores Village. Remarks (Signed) Before me, the undersigned authority, a notary public, duly authorized appeared Building Inspector My Commission Expires DATE Member Member Member Disapproved o A wictxsza, to administer oaths and take acknowledgments, personally Notary Public, State of Florida to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ 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 stated7e true. Permit No .! f -)�7 Date 7 j/ ( Read, Sworn to and Subscribed before me. Disapproved — _________________________ Date (Signed) __Date for making corrections or changes to this application after approval has been obtained from .00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 regula- tions 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 Registered Architect and /or Engineer r T Name and address of licensed contractor 1 Location and legal description of lot to be built on: Lot___, �_� ' __�_ Block_ '/ .. _ Subdivision Street and Number where work is to be done_______- State work to be done and purpose of building (by floors)_______W r ___________ __and for no other purpose. New Building Remodeling__ ___ Addition �_____ __ Repairs No. of Stories___________. To be constructed Kind of foundation_ Roof Covering_____ Estimated Total cost of improvements of Permit $ Zone cubage required y ' __—_Plan Cubage to next nearest building Size of Building Lot Maximum live load to be borne b each floor I hereby submit all the plans and specifications for said utlding. All notices with reference to the building and its construction may be sent to The undersigned applicant fo /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 work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority,' a notaiy public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 be did sign the same, and that all facts therein by him stated are true. Permit No._ __—�L� =� � ' Date___ ° C 7 ! f _ /_/ Read, Sworn to and Subscribed before me. Disapproved __________ ____ ____ Date (Signed) Building Inspector /�� Commission Expires PLANNING BOARD v v / DATE Chairman �"'' '- _- :`.•�. Member Member C / � �� / Member _,->„ Date 0 Disapproved Member Member Council Approved_ MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Date_ No._ Street. Notary Public, State of Florida to me well known, 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. • / N i ' (17 ff) MAYOR P. SCOTT KITSON COUNCILMEN PRANK O. PRUITT JOHN J. LINDSEY STANLEY MILLEDGE W. MEADE STOCKDELL ATTORNEY GEORGE E. HOLT VILLAGE MANAGER C. LAWTON McCALL icimi A2ores9illage LO R I D A VILLAGE OFFICE 9533 N. E. SECOND AVENUE PHONE 7 -1234 MAILING ADDRESS P. O. BOX 1057 LITTLE RIVER STATION MIAMI, FLA.