597 NE 93 St (9)BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed sintattu•nt or me plans and specifications herewith submitted for the build •
in 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.
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Owner's Name and Address � ' V � `�".t.A'g ..•. ._ MOO No. ... re . Street 40
Registered Architect and /or Engineer
Name and address of licensed contrtctoi 9C . �
Location and legal description of lot to be built o n �®
Lot Block
Street and Number where work is to be done _ , _.. __....,
State work to be done and purpose of building (by floors) _ �_ (C2 GLAC
be sent to.`. :..� '- .3 7704" `7
Permit No.
Disapproved .�
(Signed)
MIAMI SHORES VILLAGE
Date
Building Inspector
NOTE: A charge of S1.00 will be made for
the I'l.urnir,;; Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
Subdivision.
t tl t•p•r,T� ,TT, 1711,•TTT T „T, 0,1 -I/
t
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��� and for no other purpose.
New Building Remodeling Addition.. 3 .(iepairss No. of Stories
To be constructed of Kid of foundation Roof sCoo, ring
Estimated Total cost of improvements $ � .(6 °• & — ° J
Amount of Permit Sh.
Zone cubage required plan Cubage
Distance .to next nearest building. Size of Building Lot
Maximum live load to be borne by each floor
I hereby su mit all the pia and specifications for said building. All no ices with
9
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori
and has complied with the provisions thereof, and will require similar compliance from all cos • s or sub -
in the work to be performed under this permit; and will post or cause to be posted for ins ton on t re site
or noticcs as are required by the Act. The undersigned agrees to employ only such su work
pcnnit, as are licensed by Miami Shores Village.
Remarks (Signe
e ference to the building and its construction may
(Q 33 09.a. .
STATE OF FLORIDA, 1 .
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take
peared
Read, Sw• -- • and ' bscribed before me.
PLANNING BOARD DATE
Citair:nan Member
Member Member
Member .. ... _....._......_..._. _....... Member
Council Approved
Date Disapproved
making corrections or changes to this application after approval
when such re- inspection is made necessary by improper notice
bligations as an employer
anent Supplement,
employed by him
such public notice
formed under this
gments, personally ap-
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..
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Date 4 ))k
k .
Not Public, S/ niatta>$ia 6 3
My Commission Ercp co l : -ib a €pia ' am —tr Tyr-31, Dwane AgoAcv
Date
has been obtained frrnn
for inspection or faulty