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718 NE 95 St (7)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. Owner's Name and Address p ` c ` " a ' l 6 U'SCkf Registered Architect and/or Engineer ° 4 Name and address of licensed contractor S LJMr:1 e:7C / / C Locati n and legal description of lot to be built on: // 3 go( / I"? / Loitig A Block Street and Number where work is to be done State work to be done and purpose of building (by floors). state exterior colors (submit samples( 12GGf E--- Gl �Tz 3.0 me /4/C rra - y W 4 /V ,4 T / /4 4t?" S' ( VF - 3( cx)/C v,A9vs 7 cAvc_361v0_ /o 41/C - 5��= ' s 9 and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind.of foundation Roof Gpvering Estimated Total cost of improvements $ 2, /00 00 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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to o7 c' c,c( AVC zo yo z A7 3 3/ 7y' The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 perfor under this permit, as are licensed by Miami Shores Village. Remarks t4tRif 7e q rr7AB. 0 1CW ° 33S STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the undersigned authority, a, notary . public,. duly, authorized to administer oaths and take acknowledgments. personally appeared 'r.1 / A j 7, - 5// • �y to me well known. and who, being by me first duly sworn; upon oath deposes and says that he is the y'' / ,1 g/ � ( - � ) Z ' 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 It him stated t •e true. Permit No. £ 89 7 Disapproved ° 1 1 r Date Chairman Member Member Council Approved MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT 6 / Subdivision / W £ © & 7/c? ME S ice' Date " — L / 19 �/ p �� No. �Id Street �� (Signed Date . / / Read, Sworn to and Subscribed before me. (Signed) Building Inspector My Commission Expires p� � PLANNING BOARD DATE (/ Q7`C� e L• eizT. t 1a.- A. Mx commission E.xilires KW+ 2Qi 4- Member Member Member ate Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship.