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79 NE 93 St (8)BUILDING INSPECTION DEPARTMENT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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. Owner's Name and Address J v S Er H J . Syr 1 C 0 Registered Architect and or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: LotZi<' W= ° � ZZ Block 4 3 Subdivision Street and Number where work is to be done — 7 ci . 9 3 ' o under this permit, as are licensed by Miami Shores Village. APPLICATION FOR BBUILDING PERMIT Building Inspector MIAMI SHORES VILLAGE ell,: f. STiZ EET Remarks (Signed) Date Date 1 No i� N E. Street_ G 7s r SeZ 9 OP 191 4° Igel /5 State work to be done and purpose of building (by floors). state exterior colors (submit samples) w + A-5 U P A P . l' • t.t o c^ JtM 1"' E A!L- L �c t= ivC.LOSL TI b r : 'f BACK YV . w /c 146rlPt , LIAt GA-1 ^S •z si©E-/ G � 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 S S Amount of Permit S 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 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 obligatons 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 rm p it: 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 enploy only such sbcontractors. on work to be performed STATE OF FLORIDA COUNTY OF DADE. }ss. Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared 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 oreg.'ng application, and that he did sign the same. and that all facts therein by him stated are true. Permit No. ';fie Date Y / t Read. Sworn to and Subscribed before me. Disapproved 1 ', (Signed) lv My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Chairman Member _ Member Member Member Member Council Approved Date Disapproved Data NOTE: A charge of $25.00 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 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship This property described as: Lot 21 and the West 1/2 of Lot 22, Bieck 3, AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, according to the Plat trereof, as recorded it Plat Book 10, Pape 70 of the Public Records of [yde Florida. •7' I. @. ,,-- ® c, li J - d i 'c∎ q 0 • I • - r> • • ii • • . G; '�i i• 1 J / q?.%.k'. ri <g..5r Certified To: American Southern Mortgage Corporation its Successors and /or assigns as their interests may appear. r; f4/4 r r e ti /A) :R0 ?ERTY OF: Ser ico, 79 N.E. 93rd Street, Miami Shores, Florida. O" 77 0 iV 7 ?r v — g P.C. WO() BoAC0.5 A - - • 1 C a cEAJTEZ If 2. A woo6 Mo e Dicke FL_ • 1 1° ; 1/ i yip . ? • . " ( - 1 i I ° S.... ■!