849 NE 92 St (3)Application is hereby made for the approval of !he det,iled statemen of the plans and specifications herewith submitted for the build-
ing or oh( c , :ructure her ' described This l -, heze c is made in compliance and con o'm ty w.th the Building Ordinance of Mil ii
Shores Village, t .or da, and all pro isions of the Laws r f the State c f 1.1crid. all o d nances of M or Shores Village and all rules •u;d
regu'a ion- of the Building Dr: ' of 11111 Sho. iilage 1 '1 e o , pl ed with, whether herein specified or not. A copy ot appro;rd
plans and specificati ,ns must be kc, • at bur,d.rtg durin, progress of tl.e wcrk.
Owner' Name and Address._
Registered Architect and /or l;ngii er _ _ _._ .
Name red address of lic•en. ed contractor _
Location and legal description of lot to be built on:
Lot __ Block. _ _ . Subdivision_....
Street and Number where work is to be done. ->Q/if
State work to be done -.a ourrpse _of_building (by floors)
New Building
To be constructed of
Estimated ' .cal cost of improvements $ ....... _ Amount c ` Permit $.
Zone ^ubage required __. ..Plan Cubage_ _ _ _ . _ __
Distance to nett nearest building- __________ .._ ._Size of Building Lot .....
Maximum hv: load to ba borne by each flo ,r
hereby submit ali the plans and spocr.r.•ations for said building All itr'a •cs with reference to the building and its cnn.sta.ct may
be sent to _. _ _ __ . _ .. _ . _
The uncle signed appli ant for th s bolding pc-mit does herobv cc rtif\ i't it lte under -4a-ds and accepts Ills . blig.rtions as an cc' r
of 1 bor , order he Florida V'orkmen's Compc,sation Act bc:rg S t'on V "i':i Co. n led al Laws of Florida P r .nry S ,l .ent.
and h s enmpl ed w'th he prov':ions thereof, and will require S r:c'a: co' ran e fie t: ;.:1 contractor or sib c•ontrtdor, (An, 'c c,' k 1
in the wu k to be p rf med under th s pern it and ill post or : au to ':: sled f .r is spect'e,n on the site of the work W •1' t„:'>!. nit e
or oti es as are requir d by the Act. The u r Igo d agrees to employ n:r:' s' :.h .bron'r ctors, c-r work to be perfc r d eicr th.s
permit es are licensed by M am. Shores N =
Remarks
STATE OF 1 .0RiDA,
COUNTY OF DADE. SS.
Before me, the undersigned authority, a notary public, duly authorized to ad- , sister oaths nd cake acknowledgment ;'r onall: ‘p
pea: cd
and who, being by me first d lv , worn, upon oath depores and says that he is the
ot tli abo; de c 'bed .struction t. • 1 has carerally read the foregoing
therein by him stated are :e.
Permit No.
Disapproved
( Signed) ___
Chairman . .. .
Member
Member
Council Appro ed
Date -- -- - --- ------ - - - - --
Burldiig Inspector
Remodeling - __ _ _ .__._ Addition
Kind of foundation _ _____
_
. Date __
NOD.: A charge of $1.00 will be nude for
the Plane c _ Boa: d
A re- in•,nectron fee of $1.00 will be charged
materials and or workmanship.
0AM1 SHORES V .LASE
BUILDIiN INSPECTIOF DE AIRTMEN
APPLICATION F*R LUILD NG s` MIT
PLANNING BOARD
,Y;) �' ; Date ..
t!?
No..
to me well known,
Bead, Sworn to and Subscribed before me.
Notary Public State of Florida
My C ' a rr . n r inn Exp'-es.
Member .
Member
Me- be
application, and that be did sign the sane and :' a cts
._ DatF »i r ,. Date
:Waking correcti. ( - .4 :ages t : this : pplic•. tion Ft •r r■ pro;;.1 1. s 1 ,11 '.1. „ed from
when such re- inspect ;on is rr,. rc • es 1' improper notice t• or l'• ty
Repairs . No. of Stories
Roof Cov ring . ._
`i )'
....DATE
((.+,
Street. __
and for no other purpose.