326 NE 94 St (3)State work to be done and purpose of
Permit No
Disapproved
( Signed )
Chairman
Member
MIAMI SHORES IjL.LAGE
BUILDING INSPECTION RTMENT
APPLICATION FOR BUIt6ING PERMIT
Application is hereby made for the approyal 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 approved
plans and specifications must be kept at building during progress of the work.
Date '-' /9
_
Owner's Name and Address e:-'- I, r4"- ir 6 a _LA/ Af Street 9 / 5
Registered Architect and/or Engineer hi- s ,/J44 /f) (:' /---
Name and address of licensed contractor ___ AR J. -47
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
t:=•ekt
ilding (by floors) E - rty h A
fr?Z ,cfc9/ /
New Building Remodeling fr Addition " 1 " ----
2-S To be constructed of Kind of foundation
/°- ' ` Estimated Total cost of improvements $ cf 04 Amount of Permit $ /
...„...-/Zone cubage required _Plan Cubage_Riler 0--r 4 " s .1 d 0 /:-7 7
1 /-7..S .- (- 7 Distance to next nearest building Size of Building Lot (.1 e C:4971,5
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, 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 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.
Remarks ( Signed)._
Building Inspector
and for no other purpose.
Repairs No. of Stories
vering
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 same, and that all facts
therein by him stated are ue.
/e75- 7
Read, Sworn to and Subscribed before me.
PL NING BOARD__ DATE
Member
Member
Member Member
Council Approved Date Disapproved
Notary Public, State of Florida
My Commission Expires
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 nol:ice for inspection or faulty
materials and/or workmanship. (