70 NE 94 St (2)Lot
Block
Street and Number where work is to be done
New Building__.
To be constructed of
Estimated Total cost of
Zone cubage required
Distance to next nearest building
Chairman
Member _
Member
Council Approved.
WBAMB SHURCES dd
ll..L.DI,UG INSPECTION DEPARTMENT
AFFLPr' " TD N F LQ B MOLE DYqS FEG3 104
0
Subdivision.
PLANNING BOARD. .
0
LAME
Application is hereby made for the :.pproyal 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.
Date 4/30/71
N o
Owner's Name and Address 2' cT . , C 0 re o ran 70
Street
Registered Architect and /or Engineer
Name and address of licensed contractor__. Williams Paving Co. Inc . 670 W. 25th. S t . Hialeah
Location and legal description of lot to be built on:
70 N.E. 94th. St.
State work to be done and purpose of building (by floors)
Asphalt driveway
Remodeling ._ X -- . - -. Addition._ . ... Repairs..... _________ ____ No. of Stories
Asph. Kind of foundation Rock _. Roof Covering
improvements $ . _ .700 o 00 Amount of Permit $ J
.Plan Cubage.___
Size of Building Lot _..
,19
N.E. 94th St.
and for no other purpose.
Maximum live load to be borne by each floor___
I hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may
be sent to_ . _ Williams Pav, Co. Inc. 670 W, St.
The undersigned applicant for this building permit dots 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 such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks.- - - - --- (Signed) _ J. D G /J¢s/
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, 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.
Permit No 3 9. _ - -- - -. . -. Date.. I.1.1 CL c� ` ( - - ( I .. ._ Read, Sworn to and Subscribed before me.
Disapproved .._ .. �. D � ate n �1
(Signed) L • 'LLLf .. '1._ (CQA)
Building IiQspector My Commission Expires .
Member .. Member
Member
Date Disapproved
Notary Public, State of Florida
_ DATE
Over
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after app -r -il has b . obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper no 0 tor ins, . on or faulty
materials and /or workmanship.
11,
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