571 NE 94 St (8)MI,, .MI SHORES V!LLASE
Owner' Name and Address.__
Registered Architect and /or Engineer _ ..
Name nd 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)
Disapproved - - - - - - - - - - - - - - - - - - - - -D a t e _ __
Notary Public State of Florida
( Signed) J - - - - - - --- -
Building Inspector My Com:nis ion Expires_
PLANNING BOARD -DATE
Chairman Member
Member -- -- Member
Member Member
Council Approved Date Disa;. nro•. en
BUILCHN 1NSPECTiONi Di=PA;'2TMEN
APPLICATION FO BUILDING PE 9T
Application is hereby made for the appro. al of the det, iled statemen• of the plans and specifications herewith submitted for the build-
ing or oh, , structure her i described This r -licat:: is made in compliance and con o•m ty with the Building Ordinance of Mia ii
Shores Vi11at *e, .t .or da, and all pro- isions of tilt Law, i f the Statc of kkrid. all o d nances of Mi m Shores Village and all rules and
regu a icns of the Building Div,: i of . .1A111 Sho, illage h '1 ,e ^ol ipled with, whether herein specified or not. A copy of approved
plans and specificati ms must be kci at bundaig durin,, progress of the work.
Date , 19
No.._ _ ___. Street_ ,4 ___ �=
;____________ _____ _______ _._ __._ - and for no other purpose.
New Building. _ Reinodeling. Addition__ _ __ ___ __ __ _ Repairs. - No. of Stories
To be constructed of ._ Kind of undation._. _.. Roof Cov ring .
Estimated " .tal cost of improvements $_ �� -.� , C ' p � �C' Amount cf Permit $... ! /�__ _ - ,_ _ _ � �'•` :1j j.
Zone ^ubage required __. _. _Plan Cubage.___.
Distance to next nearest building_. .. - ___Size of Building Lot
Maximum live load to be borne by each floor -_ _ . _ __-
hereby submit all the plans and speci.ioations for said building. All notices with reference to the building and its construction may
be sent to
uncle signed appli ant for th s building pc'mit does hereby certify i'iat he under;tards and accepts his .•bligatious as an cnq
of I bor tinder he Florida Workmen's Compensation Act bong S. -t'on ':!!63 Col p Ted Gin al Laws of Florida P r anon S ippli Went,
and h s compl ed w'tli he prov• -ions there of, and will require s rnilar cot n: iari_e frown all contractors or sub contractors cniplo .ed by trim
in the wo k to be p .f mod under th s pern it and ill post or c•au' to ' e n•sted fcr inspection on the site of the work •:u •h public not e
or otices as are iequir d I-y the Act. The u ,1, r Igo d agrees to employ only scch ibcon'r etors, on work to be erfo: d der this
permit as are licensed ',ry M ant. Shores 1 it - ge. p m
Remarks (Signed) - - -
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to adir.nister oaths .nd take acknowledgments, per :onall:
geared
to me well known,
and who, being by me first d lv Sworn, upon oath deposes and says that ire is the
of th abo.. de c ibed istruction t, , 1. has careially read the foregoing application, and that he did sign the sane, and it ai 1.icts
therein by him stated are tr ie. 1
Perri it No.__ -__ _c__ Date.- .__. c__ _. . 1 _ Read, Sworn to and Subscribed before me.
Date
NOTE: A charge of $1.00 will be made for making corrections e- -•]ranges to this application .ft -r a ppro.al 1. s 1 u , -',ta tied from
the Plum ng Board
A re- inspection fee of $1.00 will be charged when such re- inspection is m: nec•es -.ar) by improper notice h r in'q t ,i,• or f v ty
materials and /or workmanship.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure her:•ir described. This application is made in compliance and corrormity with the Building Ordinance of Miami
Shores Village, Florida, and all pros isions of the Laws cf the Statt. of Florida, all o; dinances of Miami Shores Village and all rules and
regulations of the Building Div ;: in m of Mimi); Shot( 1 illage , ,h 1 be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kepi at building durin progress of the work.
Date �� - - --
,19<::
Owner's Name and Address. 44 , ; // ,4417: N _/ � 7X i
r Street_
Registered Architect and /or Engineer.
Name and address of licensed contractor _ 7 -f : -/ /;'L 'G n
Location and legal description of lot to be built on:
Lot- _-- -- -------- - --- -- - Block -.
Street and Number where work is to be done
State work to be done and purpose of building (by flogys)_______ ✓' .,
_ 1 ,, ?! � ( -7,-
� �
j � ;f - - -• and for no other purpose.
New Building_. Reiieling__ ____ ___. Addition____ ____ ___ _____ ___ Repairs_ _ _ No. of Stories
To be constructed of _._ _ ... _ v Kind of foundation._______ _ ___... _ Roof Covering_.. _.. .....
Estimated 7 ;tal cost of improvements $__. . _` r_j,5 " Amount cf Permit $ _
plan Cubage -
Size of Building Lot ________
MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Zone cubage required
Distance to next nearest building__ _ _
Maximum live load to be borne by each floor
BUILDIN`` INSPECTION DEPARTMEN"
Subdivision
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 uncle signed appli..ant for this building permit does hereby certify ihat he understands and accepts his obligations as an employer
of 1 bor under he Florida Workmen's Compensation Act. being Section 5966, Compiled Ger ral Laws of Florida, Pt.r,nanenl Supple iient,
and h s complied with the prov'sions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the wo k to be p rf -med under this permit: and " 'ill post or cause to be posted for inspection on the site of the work such public• notice
or , notices as are requir d by the Act. The u;ALnigiwd agrees to employ only such subcontrr.ctors, on work to be Perform d ,;nder this
permit as are licensed by M ami Shores \ i1lr c, 0l,9
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 ' p-
peared
to me well known,
and who, being by me first d ly sworn, upon oath deposes and says that he is the
of th abov. de,L.ibed . t,, t h. has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. t
Permit No f'_; _ , Date_ ____ Read, Sworn to and Subscribed before me.
Disapproved __. Date_
Notary Public State of Florida
(Signed)
BuildingInspeetor My Commission Expires
PLANNING BOARD __DATE
Chairman ._ ____ _ _ Member
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 hen obtained from
the Planr'ng Board
A re- inspection fee of $1.00 will be charged when such re- inspection is mt. .le necessary by improper notice for impeit'on or fa, Ity
materials and /or workmanship.