70 NE 92 St (9)/ •)
Chairman
Member
Member
STATE OF FLORIDA,
COUNTY OF DADE. j SS.
Date
D•te
MIAMI SHDIZES VILLAGE / lb
BUILDING INSPECTION DEPARTMENT r�
APPLICATION FOR BUILDING PERMIT
Application•is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for tlekbuild-
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.
� � ,� Date , 19 7
�_,- -ic r 2„— - ,— ,_ -v _7 _ Stre - -- lj t �
Owner's Name and Address _ fi L . __� _. __ . No � ___e _ --,c{
Registered Architect and/or.-Engineer . °;.:4__ _- ,
Name and address of licensed contractor___.,. , -4. -,.. > 0 24 1 _c L` n L. I K/ "' f e_'
Location and legal description riot to be built on:
Lot_l L-1 _ `�LL *- ��i rBlock / S dyisio i_
Street and Number where work is to be done 7
State work to be done and purpose of building (by floors) ! �_r_ __.__�___ ___C_ .cr;'__.,,) 4 .- C' "'''
F
/'(9,Z PLANNING BOARD
Read, Swom to and Subscribed before me.
DATE
4
and for no other purpose.
New Building Remodeling_ „_.6_,,9_ 0___' Addition Repairs No. of Stories
To be constructe of Kind of foundation L.? -4 . __4 Ro ®�overing____f , / �._ 4 a
Estimated Total cost of improvements $ 6 6 0 Amount of Permit $__d- ° . 1
, �
Zone cubage required ,/: t " _Plan Cubage _.._� _ ______'_^�
Distance to next nearest building _4_1Z?, Size of Building Lot ____ c�_ V
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 subcontractors, on work to be performed under ,this
permit, as are licensed by Miami Shores Village.
Remarks__ - (Signed)_ '=L - ' 2 '
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
Disapproved i t �/
(Signed) 7% %�/ / ... Notary Public, State of Florida
■--I' or My Cgmmission Expires
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.
t,
1
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•
/ 1' 4
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 progress of the work.
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
State work to be done and purpose of building (by floors)
MIAMI S-FreIRES VILLAGE
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor ____ _h'_i___ � ? �. __,/,_''/ 4
Location and legal description of lot to be built on:
Disapproved Date
(Signed)
BUILDING INSPECTION DEPARTMENT
P =
Date
New Building ' Remodeling Addition
To be constructed of Kind of foundation
Estimated Total cost of improvements $ 2 ___i
Amount of Permit $_
Notary Public, State of Florida
Street
0 0 6
7=71:933
Lot Block Subdivision
Street and Number where work is to be done
for no other purpose.
Repairs • No of Stories
G g_
Zone cubage required flan 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 subcontractors, on work to be erfo ed under this
Remarks_ __ (Signed) 7
permit, as are licensed by Miami Shores Village.
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 state ar tr
Permit No._ 1 Date Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
PLANNING 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- inspection fee of $1.00 will be charged when such -re- inspection is made necessary by improper notice for inspection or faulty
materials and /orworkmanship.
i
1
STATE OF FLORIDA
COUNTY OF DADE
AFFIDAVIT
bond or bonds # a5 was or were destroyed.
1, / //U44/4 , do solemnly swear that the
Subscribed and sworn to before me this /0 day of
1948.'