326 NE 92 St (13)Owner's Name and Address
# i��1)
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.
Date __.?_ f - --
,19_ --
4 , r No ,
� Street —_ __! /
i' 1`Pi
%^,. , .
Registered Architect and /or Engineer _ _l�
Name and address of licensed contractor . _2 •
Lot__ � ihti tion of lot to be built oa:
f y /
Location eg description Block � 1 L4 Subdivision________,__ � �
Street and Number where work is to be done 'Z.-, ' _ 1_2 ti
r
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Rf '4' ii :% ' ' ,e }n , deling Addition Repairs No. of Stories
To be constructed of .,„,f,. Kind of foundation Roof Covering__
Estimated Total cost of improvements $ / ra ' A t ! % Amount of Permit $
e
Zone cubage equired__________________ / ' _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 work to be performed under this
permit, as are licensed by Miami Shores Village. / a
Remarks (Signed) ! e_ k "s o ; - ' % �' e c _ "s
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, authorized to adm' is s 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 he has carefully read the foregoing application, and that he did sign the -same, and that all facts
therein by him stated e true. ,
�� / / a G, i
—
Permit No / /4 l Date ` ` f Read, s Swprn to and bscribed before me." �j
Disapproved
Date
__
■ Notary Public, Si Florida
(Signed) ,e
Building Inspecto{ My Commission Expires / 7V ir ._
PLANNING BOARD DATE
Chairman 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.
to nie well known,
•
•
1
Owner + s
Name jic,.No. ,, , Add. or Phone
General Contractor Lic.No. Add. or Phone
Zone Req.Cu.Ft. U
r ( r+ Cu. Cont . By
Plat Restriction Checked by
To Planning Board 9/,I
Re- Submitted to P.B. Approved Rejected
Plans & Spec. Checked by
To Council Approved Rejected
),
Bldg. Permit No. ' �1" //Date i ` Fee Cost
Type Stories Roof
New Construction Alterations _ Repairs
Plumbing Permit No Date
Septic Tank ++
Sewer
Misc'l
New Const.
'Electrical Permit
Fixtures
Heater
Motors
Misc rl
New Construction
Building Inspection pato By
Foundation �
Beams & Lintels
Final
Final Clean -Up
' /
Block
Plumbing inspection
Roughing
F.� x Lure a
Sewer
Septic Tank .
Solar Heater .
Final Certificate
E.ecbrical Inspection a +
Pcugaing r
Fixtures
Final _i% //(9 ,/
Tem , O.K,
. ery ce O.KG to Power Co.
t ration Repairs
No. � Dato�rFee
Ir 11
Subdivision No. Street
11
11
1,
If
t
Alteration
MINIM '
v
Approved Rejected
Re' -insp
Fee
11
11
11
11
11
Ropairs
By
Re -Insp By
Re -'insp By R e -Insp By
Re:Eisp By Re -Insp By
Cert /q