253 NE 94 St (2)MDAM1 SHORES\ \,DLl LAG(E
BUILDING INSPECTION DE14RTNIENT
APPLOCATOON FOR
U0LDONG P[
MOT
Application is hereby Linde for the approval of the detailed state1.1ent or 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 iitrilding 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.
Owner's Name and Address .... 9 R h 3 )
Registered Architect and /or Engineer
Disapproved .. Vie\ . P Date
A
Building Inspector
Seyeet_Al
W ti r2
Name and address of licensed contractor Lt.) •'V...s ✓C -
Location and legal description of lot to be built on:
Lot £ Z al Block z.. Subdivision h 1 ) , �l 1 5O /1 p_5
Street and Number where. work is to be done 2.L1..,1 t 9'7 . i
State work to be done and purpose of building (by floors)......_..... :i.! 1 0
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories _
To be constructed of Kind of foundation.. . N — 00 Roof Covering
Estimated Total cost of improvements $ 3 0 0 Amount of Permit $. Z4
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 untler.igr,cd applicant for this building permit does hereby errtify that he understands and accepts his obligations as an employer
of l hur under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Per; nemt Su »l nient,
anu has complied .‘nth the provisions thereof, and will require similar compliance From all contractors or sub - contract • emplu dd by him
in the work to be performed under this permit; and will post or cause to be r . inspectio e of the w 1 sue t blic notice
or noticcs as arc required by the Act. The undersigned agrees to employ •n y such au• tracggrs, tm war 0 be y rfo ye under this
pcnnit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss'
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 carne, and that all facts
therein by him stated �e true.
Permit No.._..al. Date 31 7 -t"T Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires _...._...___.__
PLANNING BOARD DATE
Citair;nan 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 I'I.rnnir.. Board.
A rc- ,n'pection Ice of 31.00 will be charged when such re-inspection is made necessary by Improper notice for inspection cc faulty
materials and /or workmanship.
L ` 1 co S A A 5
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THESE PLANS ARE 7P1 )F i'Tsz iSE.JA','..:::E O: A HIJILDIN:; PEWIT
ril WITH NO Vt`,RIFE! 1 ::117I VA`,;!A;.'.7.E' 1 'TED IN "REMARliS"
NO OTHER f:T"IAT:".1.* ;): '..1 T:-:7. ::,:'7.',1 S!':"..-,H : HI, rING 7
ORDIT\rx,iis , ,v1:1!. si,;;;..: i ;1 Y I ri1f,!)'11FIC'N/.
ALL (MIER APPIE;:AF;TE !':1,),TIT. M; :.,.7..)LI;FIY 1, mr.m , 31: Cr.M1'1.!ED
TI-1 EY ALL HANT!ES.
1'i
FIRE DEPARP:LI
PUPLIC WO;T:Li
A,
- .4041
POLICE 05'fR1
■ •
i i ll I 11 AVN
nit Dirx IJIREOTOR
PLANNING & 7_0Q ■:0 ‘
VILLAGE COT;CII.
APPRGVAL
—. — —
PRELIMINARY: FINAL
REMARKS:
COMPIIATI WITH - 111[ ':;!)urFi F101,:li'', IY.T.c)i.';', f;r':.
BY MIAMI SHORE:' VII I "Y.:.Ir i' Ii/-1PH 1::1: A'.ii::;!!!'',. ..',II:' IVA? Py
SUB r:0',II Th.' i ' ..'' ' ' : — !' ' r:" • ' ' li 5.
ING REGULATIONS WHETHER OR !fl r SPEr.;PlrAUY INPI■'ATIO il'...!FIN.