464 NE 92 St (3)•
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Applicat_on is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing o. other stru ture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores V:llag', F orida, and all provisions of the Laws of the State of Florida, all ord"nances of Miami Shores Village and all rules and
regulations of the Building Division of Miam Shores Village sh 11 be con plied with whether her in specified cr not. A cop of approv d
plans and specifications must be kept at budding during progress of the work.
Owner s Name and Address ___ V o Hathaway
Registered Architect and /or Engineer _
Name and address of licensed contractor _ __TRULY __NQLZN_ _.__ 600 N,- IJ , 7 Avenue, Mit1tf i,
Location and legal description of lot to be built on:
Lot_ ____ _ Block _ -- - -- - - ---- - -- -- -- - Subdivision
Street and Number where work is to be done_ r9!D__ ._ F. _92 Str?aat, _Min.m4_i Shores_,_ Fla. _
State work to be done and purpose of building (by floors)___ —_$' 1 i1GA LQN _ _- ___Ils_i ig_. VikkL-tn! _ gf15 • _ TIT 1$b an .. -_
a ro i te 20 hours exposure period, Nylon tent.
Remodeling Exm mmm1A 'rIoI�
New Building _ -_ __ -. _ _ _ g - -- Addition- - - - -- -- . Repairs - -- __ - _ -_.____- -- _ No. of Stories ___ - _ one
To be constructed of _ _ . Kind of foundation _ ____ ___ ____ ______ CBS __ ____ ___ __________.__ _ -_ Roof Covering _.Slope__ Tile
Estimated Total cost of improvements $ 210._0Q___ __._ .__ ___ __._ _ _Amount of Permit $ ._.x.00
Zone cubage required_ __ __. _ _ ___ _ _ _ ____ _Plan Cubage ___. 23,000
Distance to next nearest building_ . _ _ 15_ Ft _ _ ____ ___________ __ _ 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 h-- 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 u.,der this permit; and will post or cause to be posted for inspection on the si of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such sub _ . ctors, on wl rk to . b pe =formed under this
permit, as are licensed by Miai.'. Shoes Village.
Remarks__ _ - --- _ _. -_ -- (Signer
STATE OF FLORIDA,
COUNTY OF DADE. f ss
Before me, the undersigned authority, a notary public, duly .uthorized to administer oaths and take aclmowledgments, personally op-
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.
Per_rit No.
Disapproved _
( Signed )
Building Inspector
Date- - -- A - 0 _
Date
Date- - - _Noverab2r -- 19, - - -- ,1965
___
No ------ 464 ___ Street__ . 92
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
and for no other purpose.
PLANNING BOARD ___ _ DATE
Chairman .. - _ Member
Member — Member
Member - - Member
Council Approved Da:e 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 -in_ ect'oe 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.
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