464 NE 92 St (4)Application is hereby mode for the approval of the detailed statement ut 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, antl all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the iluilcling 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
Name and address of licensed contractor.. C.
New Building Remodeling
To be constructed of Kind of foundation
Estimated Total cost of improvements $ /® 1. ° .lx
Zone cubage required
Distance .to next nearest building.
Permit No.
Disapproved
(Signed)
.313 B
ti
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date
Date
0
Building Inspector
. Chairman
M errlber
1sfembcr .. .. --- ..._......_..._.�...._
Council Approved Date
Addition
— No.... id.'k'. . Street_.. _
41:1. 11....SI....fl? Httt 19.!• er1,11
Location and legal description of lot to be built on:
Lot W E' V i Block L/ r Subdivision.. J2' l --(�'t /
GAF' _C ( c
Street and Number where work is to be done el 14' 4- L .fV L l':? t
State work to be done and purpose of building (by floors) .l. ., ? 1 / ? 5- '' 1 ' 6 n t ''om -, ._..
,(l,� C /.4.... J, 4 /c 1). .G? .
and for no other purpose.
Repairs No. of Stories
Roof Covering
Amount of Permit S..a.C. :k
.Plan Cubage
Size of Building Lot
\faxirnum 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 ‘Vorknten's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sop pleurent,
and has complied .c ith 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 insp n on the site of work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su tra ora,�a wo be performed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks .__._.__ (Signed)
PLANNING BOARD DATE
Read, Sworn to and Subscribed before me.
STATE OF FLORIDA,
COUNTY OF DADE. j 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..
Notary Public, State of Florida
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 Pl.utnir.;C Board.
A rc•in.pection fee of 31.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.
Es; 51
1,11 / ' 1
/1" q.2
fOr