546 NE 92 St (10)BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of 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. 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 piogress of the work.
Owner's Name and Address
MIAMI SHORES VILLAGE
Registered Architect and /or Engineer...... •..
Name and address of licensed contractor
Location and legal description of lot to be built on:
{
Lot .[ Block ` ,� Subdivision.
Street and Number where work is to be done ...._ .....
State work to be done d Rurpose of building cby floors) ........,._
plan Cubage
Date..._... g am ° � 4‘ 1 ._.___. _.. G . , 19..
n\S•TSS.TtttetlSttfMTtT ?Mgt.. ., a
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories —
To be constructed of Kind of foundation J Roof Covering —
Estimated Total cost of improvements $ g e a c ` Amount of Permit $,... a. ? _
Zone cubage required
Distance to next nearest building 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 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, 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 under this permit; and will post or cause to be posted for insp on on the site of t • work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su tra tors, on work t• • pe -•r rtedynder this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
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.
Permit No.._.13l Date 7' ''' , Read, Sworn to and Subscribed before me.
Disapproved Date.
/ \ J Notary Public, State of Florida
(Signed)
Bt ilding Tnspect9(/ My Commission Expires
NNINC BOARD _.._......DATE
Chairman Member
Member Member
Me mber ...... — .._._....._..._.__.._....._ Member ...._
Council Approved Date 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- inspection 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.
//- Ea 90Z )I,A,
BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of 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. 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 piggress of the work.
MIAMI SHORES VILLAGE
Date..._...__. , lfl.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contactor �� 2... .t��..�.��d..._... ./ 'tri o
Location and legal description of lot to be built on:
Lot Block • 4 t7 Subdivision aZ
Street and Number where work is to be done 76 ._...�.�....y
State work to be done and purpose of building (by floora)........�j j.._...v F !: ._.
.and for no other purpose.
peared
(Signed)
Building Inspector
Mt Sfi!•,S,f ?SfflSH,,,f„f„
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ .6/ e e Amount of Permit $.
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 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 \Vorkmen's Compensation Act, being Section 5966, Compiled General La . s of Florida, Permanent Sup)lement,
and has complied with the provisions thereof, and will require similar compliance from all contract s •r sub - contractor employed by him
in the work to be performed under this permit; and will post or cause to be posted for in •ec t e site of the wor such public notice
or notices as are required by the Act. The undersigned agrees to employ only such au• 't.. k o be , rformed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) 1 Ail
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-
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._____._l.'
Date
Disapproved
y� Date
Read, Sworn to and Subscribed before me.
PLAN C BOARD .... .DATE
My Commission Expires �...,
Member......._ ......................._._...._........... ......_._......._... ..... _..._
Chairman
bl crnber Member ..._.._...._ ._
Member ...... _.._._....-- --• --_ ._._...__ Member
Council Approved _..._Date 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-inspection 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.
Notary Public, State of Florida
TfIll
�.....to me well known,
•
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/— — — -
.__. ,19..G "1-(,,.
Date...—Z2-7—are—z.— s — O4 .
Owner's Name and Address .....A .
teA, .... ._ .fir p _. No.. 2. g_.. S ..g ..c .
Registered Architect and /or Engineer ,,,.._ . ..1 4•11`<,.H..lt,,...,,
Name and address of licensed contractor _ .. .d r ,._._.... ` ‘z. .. ...✓ /_ ...__
Location and legal description of lot to be built on:
Lot Block Subdivision. ._ ....
Street and Number where work is to be done11......v_li- 4 N_•._.. _...
State work to be done and purpose of building (by floors)... _ .. __ -
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of 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, 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 pt'ogreu of the work.
__ and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation . Roof Covering
Estimated Total cost of improvements $.�
. /..2..
Amount of Permit $. �. Q ...
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 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 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 contracto s or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for ins•egion • he site of the wor such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su • o work to be , rformed under this
pennit, as are licensed by Miami Shores Village.
Remarks..._ (Signed)
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
Notary Public, State of Florida
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. J/
Permit No ..__ _ L a:� _ Date. }I,
? � — Read, Sworn to and Subscribed before me.
Disapproved ®� ...c of to
(Signed)
Building Ins : tor My Commission Expires ......— ........ _.....
_..._.._.
LANNINC BOARD _.._ DATE
Chairman Member
MemberMember ..._ ._ ....._...._......_.._..._..._ ........ __..........._...._.._
Member ...... __..._....._.---- _.._._....._ Member
Council Approved Date 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-inspection 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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