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54 NE 95 St (3)STATE OF FLORIDA, COUNTY OF DADE. j ss • (Signed) Chairman Member MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING 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. i Owner's Name and Address.__ .__.o e° - ; Registered Architect and /or Engineer Name and address of licensed contractor 1nz !.!. '4 Location and legal description of lot to be bu jlt on: A 7 '., 6 Block �, Street and Number where work is to be done_. State work to be done and purpose of building (by floors)___C i __2___e_ __ ____ Subdivision l J' ZZ --k • z, , Ic6 �/ Date f --- - - --- - -• ---- - No.. s � Street_. /X4. � ' Ly J'' C- .417 4.; and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation; Roof Covering Estimated Total cost of improvements $ 7 7 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, 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 inspec ion on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcoptactors, on work to be performed under this )- Remarks___ (Signed 1 permit, as are licensed by Miami Shores Village. r k . __. ��� C - Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknovGfedgments, 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 true. l (c `- p s rf z Permit No.__________.. Date Read, Sworn to and Subscribed before me. Disapproved ...c- _ . ' Date_ — Notary Public, State of Florida Building Ins ector My Commission. Expires PLANNING BOARD DATE 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. •or) 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. j r jj /n Date 's/t1' — — -- _ – 19 ----- Owner's Name and Address_ _____ F " r"__ .-� �S,L ��__ —_ _____________ No. ___ ___ ms —_ Street— :.G____ =' . `_�! � Registered Architect and /or Engineer_ Name and address of licensed contractor Location'and legal description of lot to be buflt on: Subdivision K;1 ___ ' ' _ Street and Number where work is to be done __,. % f ! ;w' _____ �— Permit No Date Disapproved — ___________— ______ —___ Date (Signed) 1 / State work to be done and purpose of building (by floors) / _.t1 ' '' Pr - -__ — __and for no other purpose. New Building emodeling_________________ Addition__— ___— __— ________ R. cg airs_ _________________________ No. of Stories To be constructed of 'JILL' _ Kind of foundation ' r2�_! =_ y____— Roo". Covering_ Estimated Total cost of improvements $ 7 - . " "V _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 s)}b'init al the plans ra specifications for.sa ilding. All notices with reference to the building and its construction may / be sent to ' I . The undersigned applicant for this building permit does hereby certify that be 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- contracto 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 w such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcopriktora, on woph to be rformed dw► this permit, as are licensed by Miami Shores Village. Remarks (Signed) Read, Sworn to and Subscribed before me. Building Inspector My Commissio:a Expires Notary Public, State of Florida PLANNING BCARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a not.;.ry 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. .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.