913 NE 95 St (8)*mi ami shores*
MIAMI SHORES
*MECHANICAL*
MECHANICAL
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement us we 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 Miarni
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 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.
L D IN GI i N4 Date.- •_- •.__ -_ . -� __ 19.__
Owner's Name and Address _ No..._. Street/ LE
Registered Architect and /or Engineer
Name and address of licensed contactor
Location and legal desFriptt'°n of lot to be built on: p
Lot. /. 4P W / al 0' J0 Block 2 �? Subdivision. ,,.,,Q. 3 l/ ^ ° 1 / LW, t
Street and Number when) work is to be done ar—L.. '7
Stato work to be done and purpose of building (by floors)
1 IN S TA L_ L.,, As1e .._.. 1.A.)`D..0 (-0 I._t
rep o0 Aa 0
Estimated Total cost of improvements $
Permit No.._..GZ2 7 ‘cZ _.. Date
"\ \ k '
Disapproved
(Signed)
V Date.
V
VIII* IMO ••Ile • ,n.»nvwr,
and for no other purpose.
Ncw Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Amount of Permit $. 6 9
Zone collage 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 u 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, Perinanent Supplement,
noel h.ts cnmphcd scith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hips
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 subcontract • s. on to be performed under this
permit, as are licensed by Miami Shores Village.
Retnuks (Signed)
6 of9d, '95V
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 brown,
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..
Read, to and Subscribed before me. •
L
Notary Public, State of Florida
Notary r .. blic, Stab of ievk
Building Inspector • My Commission Expires tinissitin - E>ipsfea �1►
PLANNING BOARD DATtadod Thru Troy fain • tn4r9R69 IRE.
Chair;nan Member
\lerc,ber Member
Member .. .. Member ...._
Council Approved Date Disapproved Date
NOTE: A c•h.,rgc of $1.00 will be made for making corrections or changes to this application After approval has been obtained from
the P11nnir,g Board.
A rc•in.pection fee of 51.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty
materials anti /or workmanship.