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78 NE 93 StMil i U ' U [ l SHORES V I L L GE BUILDING INSPECTION DEPARTMENT AFPLOCATI ® FOR :X91L ®Ii`9G fPERMlIIT be sent to Remarks (Signe Application is hereby wade 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 progress of the work. y, /� Date..._... Owner's Name and Address ....Y.X.eiQ ie . �i � --- - No R egistered Architect and /or Engineer qq ,.,•• ,., ,. ;..: ............. ... .-- ,..... Name and address of licensed contractor... ..l d e•r 0.)!3!DQ V? -. 4- .• )..• 4..,.....i ' Location and legal description of lot to be built on: Lot Block Subdivision G� Street and Number when; work is to be done - 24) A-. r C - - T - r - • - •• -- — - S to work to be d ne and purpose of building (by floors).•tOP..)41..� � fi gi 4 59 - and for no other purpose. Addition Repairs No. of Stories New Building Remodeling To be constructed of Kind of foundat . Roof Covering Estimated Total cost of improvements $. / ..� -�� Amount of Permit a. 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 The undersigned applicant for this building pennit 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, Pennanent 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 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 subco tractor t, on work to be performed under this pennit, as are licensed by Miami Shores Village. peared STATE OF FLORIDA, COUNTY OF DADE. 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 s cv Date / �' 7 Permit No . Read, Sworn to and Subscribed before me. .._._ � � Disapproved ....... - _ ( . f / . Date- ....... _.... � C Notary Public, State of Florida ( Signed) - ....... Building spcctor My Commission Expires Sts� eetl..r b ..� to me well known, PLAN .. NC BOARD DATE Chairman Member Member 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 fee of $1.00 will be charged when such re- inspection is mode necessary by improper notice for inspection or faulty materials and /or workmanship. ss. M 8 A N1 8 • RES VILLAGE BUILDING INSPECTION DEP/ARTMENiT APPLOCATOO F R EzLOOLDING PE MOT peared Disapproved .... Dat Notary Public, State of Florida (Signed) ) - 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 progress of the work. le n/ t Date Owner's Name and Address.� F�-O ll.. � h ' - A Registered Architect and /or Engineer ' _..gaga Name and address of licensed contractor.. / V 1( ? //•/ DOW 4 . /b = No . / Str eetLY Location and legal description of lot to be built on: Lot Block Subdivision M..• - -.• •._ Street and Number where work is to be done ^_ to work to be dons and purpose of building (by floors) iha __. . ..> —� � -� S ) �s _/ � J' .)f / f iQ e H ,449 2 'l t 4C e - and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of found�tw Roof Covering Estimated Total cost of improvements $ 3 °° Amount of Permit t. 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 pennit 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 hint in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as arc required by the Act. The undersigned agrees to employ only such subcon• ctors, on work to be performed under this pennit, as are licensed by Miami Shores Village. Remarks (Signed Building InspccTr My Commission Expires STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, 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 staked are true. Permit No..____ I Date _ Read, Sworn to and Subscribed before me. ANNING BOARD DATE Chairman Member Member 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 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.