695 NE 93 St (7)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for thc approval of the detailed statement us the plans and specifications herewith submitted for
in or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance ,
Shores Village, Florida. and all provisions of thc Laws of the State of Florida, all ordinances of Miami Shores Village and all r
regulations of the i.luilding Division of Miami Shores Village shall be complied; with whether herein specified or . A copy of a,
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address . \ZOt .i� a • ...._ N � No »....»...._..._... Street_...._..
Registered Architect and /or EnOncer
Name and address of licensed contractor __ 1
Location and legal flcscr iption of lot to be b ilt o :
Lot... f-'�..� .1'�4f � Block
,
Street and Number where work is to be done
State work to be done and purpose of building
New Bui!ding Remodeling
To be constructed of Kind of foundation
Estimate Total cost of improvements $
Zone cubage required
Distance •to next nearest building
Maximum live load to be borne by each floor
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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 h
therein by him stated are true..
Permit No...
Disapproved
(Signed)
Building Inspector
Date 9 (
Date .._......._
v sion ..
► �
(by floors)._ ' .6�r
r
2
Addition Repairs' No of Stories
Roof Covering .......t ...1.4 (d..
$
Amount of Permit
.Plan Cubage
Size of 3uilding Lot
Read, Sworn to and Sub
and for no other purpose.
l
I hereby bmit U the�planss and pecifications 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 5963, Compiled General Laws of Florida, Prominent Sup t lt•uient,
from and has complied s.itli the provision% thereof, and will require similar compliance fro all contractors or sub - contractors employed by hint
in the work to be performe tinder 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
pcnnit, as are•licensed by Miami Shores Village. �, _\ ,`'
ltemuks (Sign x 1 �� t �:"° 4 t a tv
aa2
Bcfo e, a and r igned au ority, a notary public, duly authorized to administer oaths and take acknowledgments. personally ap-
peared , - • .
....to me well known,
e, and that all facts
Notary Public ate of Florida._ _ _ ,
My Commission
PLANNING BOARD DATE
Citair:nan Mem:ycr ....... ....................... _._..._ »........... -----
Member Member
Member .. :. _...__....._..._._ ...._....... Member
Council Approved Date Disapproved Date
NOTE: A ch.irge of $1.00 will be made for making corrections or changes to this application after approval has been obtained fait
the Pl.tnnir.;; llo.ird.
A re fee of SI.00 will be charged when such re- inspection !s made necessary by Improper notice for inspection or faulty
materials anu /or workmanship.