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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.