87 NE 93 St (3)Sr
•
Application is hereby wade for the approval of the detailed statement us 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 Flurie]a, 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
MIAMI SHORES VILLAGE
APPLICATION FOR BUELDINO PERMIT
BUILDING INSPECTION DEPARTMENT
11 -0 1 2 � .`!1._.....(CZ ..... ._ No— ._ .. .._ . Street,.ly .. a1.3. 51
Registered Architect and /or Engineer ,,,,. n,•••,,,•,r,,,,,,,, »,•,•,,,
Name and address of licensed contractor 0 M Kl f2-12
Location aytd legal description of lot to be built on:
Lot. .. , .. .` .2_, 4-013 Block 3 Subdivision 7 451,1/4J ''L g _ .. ._— 11 f.4. .. J Y /
Street and Number where work is to be done
State work to be done and purpose of building (by floors) ....... Q 9..... c .._. ......e:' .1.�...._.
"ffic ( . TINA .._.. 1. -1 CA .... .
and for no other purpose.
New Bui!ding Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Amount of Permit $. ..'!YtE
.Plan Cubage
Size of Building Lot
Estimates Total cost of improvements $
Zone cubage required
Distance .to next nearest building
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
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gen aws
and has complied with the provisions thereof, and will require similar compliance f all ntrac ors
in the work to be performed under this permit; and will post or cause to be posted
or notices as are required by the Act. The undersigned agrees to employ on3y such
pcnnit, as are licensed by Miami Shores Village.
Remuks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. d ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 tru
Permit No.._. �_.� e
Disapproved w Date.
(Signed) e
Date
Building Inspector
1 1
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
accepts his obligations as an employer
lorida, Permanent Supplement,
- contractors employed by him
of the work such public notice
to be performed under this
to me well known,
PLANNING BOARD DATE
Chairman Member
Member Member
Member .. .. _ ....._......_..._.,...._....... Member
Council Approved Date Disapproved Date
NOTE: A charge of $I.00 will be made for making corrections or changes to this application niter approval has been obtained froth
the 1' ,tnnir.g hoard.
A re inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection at faulty
materials ane /or workmanship.
/99
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.
Owner's Name and Address.. "Y ,9
Registered Architect and /or Engineer
Name and address of licensed contractor._
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done
State work to be done and ose of buildi
STATE OF FLORIDA, I
COUNTY OF DADE. j Ss.
APPLICATION FOR BUILDING PERMIT
permit, as are licensed by Miami Shores Village
Remarks
Date _..7
/
Disapproved
( Signed) ?l�
ilding inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Su division
Date
(Signed)✓
g (by floors)
l■1/4'
®TL AO2z fe /
No
aLy
9
(0
Street.
Read, Sworn to and Subscribed before me.
24,g0 A-)t l 2 tSk.
and for no other purpose.
New Building Remodeling
To be constructed of Kind of foun
Estimated Total cost of improvements $ � ._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 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 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 s. bcontractors, on work to be performed under this
Addition Repairs No. of Stories
Roof C ring
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 .- 1....
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chainnan 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- inspection fee of 51.00 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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