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410 NE 94 St (3)Registered Architect and Engineer Name and address of licensed contractor __ Lot ft* 12__i Block Subdivision Street and Number where work is to be done 7 CO sY Q9v 0 -- Disapproved (Signed) Building Inspector 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 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 ' I1 19 t A bclPirdV { sJ /" °t' I> 41 0 Street_ P& location and legal description of lot to be built on: I1 -fi 2O 1 " 42‘7 2 D 6ho.ktose.., • State work to he done and purpose of building (by floors). state exterior colors (submit samples) 1 / h Ji Xi // DAJe J C sR;- ¥r - r s-1/41 _--m . wt. 3gT O L c r2 /0* 1371/4/47-7 and for no other purpose. N s 1 G ` Repairs No. of Stories___— _ 'lip he constructed of __ Kind of foundation Roof Covering_ Estimated Total cost of improvements 8 Zone cuhage required Plan Cubage Distance to next nearest buildi Size of Building Lot Maximum live load to he borne ht each floor hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to - Remarks (Signed) Date Amount of Permit 5 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat.ons as an e .lover of Labor under the Florida \Corkmen'q Compensation Act, being Section 5966. Compiled General Laws of Florida. Permanent Supplement. and has complie the pr visions thereof. and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this pe it: 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 : rploy only such subcontr ctors. on w to be performed under this permit. as are licensed by Miami Shores Village. i SPATE OF FLORIDA COUNTY OF DAl)E. } ss. 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 carefully read the foregoi application. and that he did si:n_% same. and that all facts therein by him stated are true. �y�,, SYLVI EXPIRES Permit No °v �� f Date /��i4� Read. S18�ir� t� 'bed be N ' 1 >: BONDED THRU NOTARY P 1 N. ar• State of Florida Notary Public, State of Florida My Commission Expires _MY ComTAissien_1tp}y_jf— ;1989 PLANNING BOARD DATE Bonded Thru Troy an - Insurance, Inc Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of 525.00 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 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials And workmanship Permit No Disapprove (Signed) Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other struct re he.rcin 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_.__ I , 19 -7 Owner's Name and Address .. M. • P __u No 4 Street F_ • f� S� Registered Architect and /or Engineer Name and address of licensed contractor , / [l L 7 rl e' 1 4 IA/ Location and legal description of lot to be built on: Lot J/ # /a. Block Street and Number where work is to be done I3'r'? BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT MIAMI SHU ES VILLAGE Date Date__ Subdivision ■5' C • t71' State work to be done and purpose of building (by floors)____._ST! 4 L 6 3 To A/ ,s,vr2 ST. /t7/ /+(i - -- and for no other purpose. New Building Remodeling AdditionRepairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ 0 0 Amount of Permit $� 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 dement, and has complied with the provisions thereof, and will require similar compliance from a - tractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for ' spec "one th -e o f work such public notice or notices as are required by the Act. The undersigned agrees to employ only such s •contr• . ii • Q' ► • performed under this permit, 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 same, and that all facts therein by him stated are tru �j Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector, MyCommission Expires PL INC BOARD DATE Chairman Member Member Member Member Member Counc,. •.Approves. Date Disapproved Date NO:E: A c1,.trge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning 3o.::6. A re inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.