825 NE 92 St (7)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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
plans and specifications must be kept at building during progress of the work. -70
Date
� C � t'1• 2- ,19.1_ = -Y
C �
Owner's Name and Address
{�
1 � P1J E No 8 i E Street - ST
Registered Architect and /or Engineer t ,
Name and address of licensed contractor
Location and legal description of lot to be built on: y�
eF / // �« a' Block % o,- /3 Subdivision Gas- '
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
" 6 2 le- //3)/e_
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 $ Amount of Permit $' ---1=
Zone cubage required plan Cubage_ __-
_Size of Building Lot
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 .. _ --
s9a- ,c C o / . t i c - • 7 / 8 5 / 1 / . ,
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, 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 c quire
by d by the A ct. h Vi nundersigned agrees to employ only such subcontractors, on work to be performed under this
permit, Remarks----------- - - - - - - (Signed)._
—
STATE OF FLORIDA, ss
COUNTY OF DADE. J •
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 ar tr dd /
� _ Date ( - .
Permit No.— __ -- ate Read, Sworn to and Subscribed before me.
r/ ---- _ -
Disapproved Date__- ---- ----- -- - - -- - --
- � . j "" f _ - -- Notary Public, State of Florida
( Signed)
Building Inspector My Commission Expires
PLAN NG BOARD DATE
Chairman -- Member
Member _____ Member
Member
Member Date
Council Approved Date Disapproved
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.
•••. • - >cc
1
1
Owner's Name and Address
Disapproved
\ /f 1. — �
(Signed) .: 2 ��'--- ` - -�.. _ . ,�
Building Inspector
Chairman
Member
Member ...... — _.___..-- . • - - -._ ...__._ _
Council Approved Date
NOTE: A charge of $1.00 will be made far
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials anti /or workmanship.
MIAMI SHORiES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement o5 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 budding during progress of the work.
r„r 7. 6.1 2
Registered Architect and /or 1nSint:er
Name and address of licensed contractor fi 6 4 "V 1 )) G •
Location and legal description of lot to be built on:
09:1. . 990•• Tltt••llTT9..T•99T•••T9l
9c C,' L3,ov e �� ( a 6 /-e' o
c rr r �/ at'
Lot..l.L. Bloc S ubdivision.'
. , y :4, f Ld,r>a c° c�
Street an Numb r whe a work is to be done ? a' S _ A ' E
State work to be done and purpose of building (by floors). ,e-'
r-
/‹ pY wc. ...__ g ..._ -._.
e.iG sv 7N t 3 1 ..... - - . �` ��� ..: a ,..: 1- :.
and for no other purpose.
New Building Remodeling Addition
To be constructed of Kind of foundation, Roof Covering
Estimated Total cost of improvements $.... czZi 6 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 subeontr ors, on work to be rmed under this
pennit, as are licensed by Miami Shores Village.
Remarks..._ (Signed) _.e
STATE OF FLORIDA,
COUNTY OF DADE. 5 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 tame, and that all facts
therein by him staAed are e. -
Permit No _ _ _ .- _ Date....._._ ............._..., Read, Sworn to and Subscribed before me.
PLANNING BOAR 0)
Notary Public, State of Florida
My Commission Expires ......._......._........
Member
Member
Member - -._ -_
Disepprov Date
1
.-» N0.. IC (AT .._. Street . f -. . , r �
Repairs No. of Stories
DATE
to me well known,
making corrections or changes to this opplicatieae after approval has been obtained from
when such re- inspection is Redo nseemary by Imp oiler notice for iaspeviion et faulty