349 NE 93 St (2)To be constructed of Kind of foundation
Estimated Total cost of improvements $:_k
Zone cubage required
Distance to next nearest building
Maximum live load to be borne by each floor____ . ...._.
Chairman
Member _
Member
Council Approved
MIAMI nu VILLAGE
BUILDING :EON DEPARTMENT
APPLICATI® LIILDING PERMIT
Application is hereby made for the approval of the dazaleed.: tatament of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is mad.r in compliancz 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 shat be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progreL:. of the worn.
Q g
Owner's Name and Address . S0__,_
Registered Architect and /or Engineer. _ _
Name and address of licensed contractor___ i
�
-
;A
Location and legal description of lot to be built on:
Lo. ___ Block Subdivision
0
-, A .
A
Street and Number where work is to be done 17)
2
State work to be done and purpose of building (by floors)_. _ _____________ _ _:_ \?
LC
and for no other purpose.
New Building Remodeling Addition _ _ _._ ._ Repairs_. No. of Stories
- ----- .... . - _.. Roof Covering
Amount of Permit $__.._ ___ 6,
"
_Plan Cubage___
Size of Building Lot__
1 hereby submit all the plans and specifications for said buflding. 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, Pennanent Supplement,
and has complied with the provisions thereof, and will rec similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post cr 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 wori to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks________ -- - - - - -- - _
i
PLANNING BOARD
(Signed)
Member _
Member
Member
Date Disapproved
NOTE: A charge of $1.00 will be made for makirg co reg ions or changes to
the Planning Board.
A re- inspection fee of $1.00 will be charged when si h re- :nspection is made
materials and /or workmanship.
Date-- -- -- - - -. i !3 C / `)
No... � G _ . Street
STATE OF FLORIDA,
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 him stated are true.
Permit No _ v___ Date. _ U — __ / Read, Sworn to and Subscribed before me.
Disapproved __ . ___ Qate____
(Signed)
Bmlding%Inspector My Commission Expires
Notary Public, State of Florida
_DATE
2 7e7
Date
this application after approval has been obtained from
necessary by improper notice for inspection or faulty
•
NE 73 sr
W ; e N v,
1:;7e4