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795 NE 95 St (14)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. Owner's Name and Address - 14 • 2) R Q a Registered Architect and /or Engineer Name and address of licensed contractor_____ Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) Date_ /I , 19 ✓ No.? S treet —i✓ Cs _ ---- _�_- -- _ - -_ -- _ -- __ -- __and for no other purpose. New Building______ .... —_ ____ Remodeling- ____—___ —__ Addition__ ___ —_ _____ Repairs No. of Stories_ To be constructed of_____—____________ Kind f foundation ___________— Roof Covering Estimated Total cost of improvements $ ( O. 0 ______Amount of Permit $-- 0 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 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 suc ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subco actors, on work to be perfor +under this permit, as are licensed by Miami Shores Village. Remarks • Disapp .'ved 7a--rjt — Date (Signed) % 7 Chairman Member Member Council Approved_ Building Inspecto STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, appeared 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. Permit No._ __ Date - // Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires personally to me well known, PLA NG BOARD DATE Member Member Member 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. 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. • Date_A_ _— -Z• '(� __ ____ L ____, 19 Owner's Name and Address �•'� • A • DR 0a, a No.? S J'— Street —i✓ 4 Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot__ — ^______ Block_ Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT New Building Remodeling_____________ Addition_______— ________ Repairs No. of Stories_ To be constructed of Kind/of foundation_________ Roof Covering_ Estimated Total cost of improvements $_ CP 0 0 ' _— ,_Amount of Permit $._ 0___ 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 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 suc ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcorractors, on work to be erfor under this . permit, as are licensed by Miami Shores Village. Remarks (Signed) 444 CoW STATE OF FLORIDA, t COUNTY OF DADE. 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 foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No._ ®.•t`I_ V,__ Dated / / Id Read, Sworn to and Subscribed before me. Disapp ved "_ __ _ Date (Signed) �' •� L � wilding Inspecto ri Council Approved_ PLA ING BOARD DATE Chairman Member Member _ Member Member Member — Date Disapproved Notary Public, State of Florida My Commission Expires and for no other purpose. ___Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been optained 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. BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ PLUMBING ❑ PERMIT N° 9721 ROOFING ❑ FC.i: ❑ Owner of Building Architect Contractor or Builder Legal Description Address of Building � ,ai ■ N d • +ti! � / 7 N 1�" Lat " M BI 6 I ?I 1 Date Z Z 19 : Contractor's License No. Work to be performed under this Permit Subdi- vision ff 3 Sq Ft Value of of Project $ Q 11 Permit $ r This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any ,plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans gr drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants employe06. r i / Signed t.----,4 CTOR) BY In consideration of the issuance to me of this permit I agree,,to perform the wor vered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawing "s tements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work don by either, myself, my agent, servant or employee. COIITRACTOR o/ BUILDER BY 1 . AUTHORITY