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79 NE 93 St (3)BUILDINGS INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby uunde for the approval of the detailed statement ut the plans and specifications herewith submitted for the build inc or other structure herein described. This application is made in compliance and conforTn ty with the 1uilding 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 vles and regulations of the i3utlding Division of Miami Shores Village shall be complied with, whether herein cspecificd or not. A copy of approved plats and specifications must be kept at building during progress of the-work. Owners Name and Address . ... Registered Architect and /or lengincer.... .. : »- •- •••_••- -.••• —•w . Name and address of licensed contal4's�''s /_4&�.%�d ctor .�. _ • 6 peared Ctair:nan Member Member MIAMI SHORES VILLAGE Location and lcga1description of lot to be built on: ' Block._ .. .. Subdivision ' J / Street and Number where work is to be done ` State work to d ne and purpose of building (by floors; New Building Remodeling To be constructed of Estimated Total cost of Zone cubage required Distance•to next nearest building Maximum live load to be borne by each floor Addition Kind of improvements $. ». ".•;:.� 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 5066. Compiled General Laws of Florida. Pertnxnvnt Siip`tleutent, and has complied utith the provisions thereof, and will require similar compliance from all contractors or sub- cnnttactors employed by hint in the work to be performed under this permit; and will post or cause to be posted for inspection on tan . 'te of the work such public notice or noticcs as are required by the Act. The undersigned agrees to employ only such subco, ors. pit to be performed, z eder this permit, as are licensed by Miami Shores Village. Rein uks..._._ »..... — — — .._.. ».____. ._Amount of Permit Size of Building Lot .....__ . ... ».»___ .....__......._..............._ Repairs _Plan Cubage. (Signed)_ Date s _ "�- / / and for t© other purpose. No. of Stories ).co f Coveting_ .......... . »..... ....... _...._.._s, C' ? 1 STATE OF FLORIDA. 1 ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public„ duly authorized to administer oaths and take acknowledgments, personally ap-• -to Erse 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, azd that all facts therein by him stated are true.. 1 Permit No.. I ��_. ».. Date mad ( �� ............ Read, Sworn to and Subscribed before me. Disapproved _. (Signed n . '.. ........... Date.. Building Inspector My Commission Expires ..._._._........__.®_._...�_� Notary Public, State of Florida PLANNING BOARD..._.._ _.._._...._DATE Member M ember _. ._...._._...._ _ • Member...._ — ._...__......_.... _ _.., »... Council Approved ....__._Date Disapproved ......_.._.._.__ Date \UTE: A ch.trge of $1.00 will be made for making corrections or changes to this application after approval has been r: gained; f a " - the I'Lannir.., ltu.ard. A re- tnspet Lion fee of 51.00 will be charged when such re- inspection is made necessary by fro-gaper notice for ins ' otr Leol_ty materials anu /or workmanship.