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307 NE 95 St (3)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 building 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 regula- tions 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. 19 1' Owner's Name and Address f Al No .__ n Street_�� f 1 7 Registered Architect and /or Engineer �-� *..-■ Name and address of licensed contractor Location and le aa description of lot to / built on: 2q Subdivision "( Street and Number where work is to be done 1L I 4 add q J ?� y � y� t State work to be done and purpose of building (by floors) a dCit C"e-1 - ^' (e ms' 8 t »,✓1' e u S ell fir ,a•r'!' _and for no other purpose. New Building ✓ _ — ___ Remodeling g ___ Addition 1� Repairs No. of Stories_____ �_______ To be constructed of_rel,.,_ !�' rnd of foundation S,14tx `i1!'r�!�±� Roof Covering_ —__7 Estimated Total cost of improvements $ � ° ' G' C. 1_t STATE OF FLORIDA, COUNTY OF DADE. .z� , .k Q • 9 fr 1:r . Disapproved _______ —____ —_ - -_ Date (Signed) __Amount of Permit $__ Building Inspector My Commission Expires Notary Public, State of Florida 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 e specifications for said uildi. 11 notices with reference to the building and its construction may be sent to fiery �rr,a� 1 I(.L[.t 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. 1 1,15 � / ' A,L. Remarks (Signed) ; Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 carefyily read the foregoing application, and that he did sign the same, and that all facts therein by him stated areett e. Permit No._ ¢ 3 e. __ _ Date /' L Read, Sworn to and Subscribed before me. 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 /or workmanship. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 6-01-93 Job Address 307 NE 95 STREET Tax Folio // SaVe /LJ Legal Description /' /1 9 LE £& / ij T -S, / Owner / Lessee / Tenant OSTERGAARD Master Permit 4��7�;/ C Owner's Address 307 NE 95 STREET Phone 759 -5682 NORTH DADE SEPTIC TANK Address 800 NW 111 STREET Contracting Co. QualifierDENNIS NEVILLE Phone 754 -3375 y as to o L`rac ,kor or Owner - Builder My CompAii RAFe ::-LC.^,IDA AT LA2:'5 NY 4OMMISSION EX ?:R:a .I: ?!y 19, 1975 . fONDED THIU HUCKLE3 Y NOTARY TOTAL DUE t5n * * * * * Electrical gineering