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863 NE 92 St (6)Application is hereby made for the approval of the detailed statc,,,r•nt ur rile plans and specifications herewith submitted for the build inc or other structure herein descrbed. This application is made in compliance and conformity with the Building Ordinance of Miarni 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. rr�Q /�� Date..._..._....... ..__(.L&tL..._ .( _.. , 1ffB4? Owner's Name and Address ..... /lL:......._ ( //� _. No.. ` ..... Street._ . slZ"" Name and address of licensed contractor Disapproved (Signed) BUILDING INSPECTION DEPARTMENT MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Date Registered Architect and /or Engineer Location and legal description of lot to be built on: Lot Block / Subdivision... ivir // 3� ?� ©S — 'a '' .5 ....... ........ Street and Number where work is to be done 863 N 1 _ 9, _ State work to be done and purpose of building (by floors) _ `/ /N,�Z1gt� Ch/9 /N ,Ljw� kiA/Gfi_. -2 r:....id ../A 14/ Access 6/34 New Bui!ding Remodeling To be constructed of Estimated Total cost of improvements $ /00 O OTft/a.J ja and for no other purpose. Addition Repairs No. of Stories Kind of foundation Roof Covering Amount of Permit S. 6-0° 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 Sup clement, and has complied with the provisions thereof, and will require similar compliance from contractors or sub - contra •rs employed by him in the work to be performed under this permit; and will post or cause to be posted fo trap ction on the site oft rk such public notice or noticcs as are required by the Act. The undersigned agrees to employ only such s beon • actors, on work . - perf • ed , under this pennit, as are licensed by Miami Shores Village. / Remarks_ (Signed) ( 4. STATE OF FLORIDA, COUNTY OF DADE. i 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 � ar re e true. Permit No.. 2e v 1 Read, Sworn to and Subscribed before me. < Date Building Inspector My Commission Expires Notary Public, State of Florida LN6r to me well known, 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 Pl.innii.g Board. A re-inspection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspevtinn or faulty materials anti /or workmanship. w a S;i2L r v \ o"i i., 6 01 ,14- A M i t-y RtJ I DCpGL