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10 NE 97 St (7)MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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 — 6 7/ 3 — No Street Owner's Name and Address 404. 04 `0 Registered Architect and /or Engineer � Name and address of licensed contractor_ .._b C ( kr __ D Ai 6 0 LE_Q C and legal description of lot to be built on: Lot Block Subdivision � Street and Number where work is to be done__ ___ _ 14 L . ' �� / State work to be done and purpose of building (by floors)__ __,''^, ay— / i,�a[3 STATE OF FLORIDA, COUNTY OF DADE. ss Disapproved __ __ __- Date_ (Signed) 12 and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering t c.. © cn Estimated Total cost of improvements $ t ' Amount of Permit $ - ' 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 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 __ ___ t._ 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 d B Date �> " 4 �' " Read, Sworn to and Subscribed before me. Notary Public, State of Florida Buildingc� 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 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. (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement ur ore 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 Divisinn of Miami Shores Village shall be complied with, whcther herein specified or not. A copy of approved plans and specifications must be kept at budding during progress of the work. c Owner's Name and Address ... Registered Architect and /or Engineer Mr7 5;1- NII11C and address of licensed contactor $ " 5 L'�b' .Jf?ss..'5t 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 budding (by floors) No 0 /...:...... Street 7 - 4../ LI Date-, Aar oc Disapproved • .. Date Notary Public, State of Florida iii `f y and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering �, Estimated Total cost of improvements $ � �' Amount of Permit $_. / ( .._ Zone cubage required Plan Cubage Distance to next nearest building.. Size of Building Lot Maximum live load to be borne beach 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 unrlersicncd 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, Pennanrnt Supplement, an has complied ss ith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort; 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, o . worlylto be P9r;ormed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) Building Inspector My Commission Expires STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, per 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, said that all facts therein by him stated are true. /� Permit No ",10 Date ... � .. ..// Read, Sworn to and Subscribed before me. 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 been obtained fmm the 1'I.rnnir,4 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. MIAMI SHORES VILLAGE BU:L.DING INSPECTION DEPARTMENT APPLIrtTION FOR BUILDING PERMIT Application is hereby made for the approyal 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. alnua,7y 29 , 70 r . B. Daroff 10 1;:L, 97 St. Owner's Name and Address D - ° R No Street . Registered Architect and/or Engineer_ Name and address of licensed contractor ... Dade Gas Corclaa3.1. y„ 955 E 2 5 5' t Q Ilia Location and legal description of lot to be built on: ``• Lot Block Subdivision /i Street and Number where work is to be done 1 9 ..../ State work to be done and purpose of building (by floors)._ 2 ne. P00: T. t: C.:.' / Disapproved _. _ Date .. ( Signed) ,,e ,S,,„-:.-1_,,,_, ,_,. - - 13uilding Inspect I 1 e Chairman Member Member . Council Approved Date and for no other purpose. New Building Remodeling Addition Repairs No. of Stories L i To be constructed of Kind of foundation Roof Covering_ Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required _Plan Cubage_ Distanc, to hest nearest building Size of Building Lot_ Maxim live load to be borne by each floor__ hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may sent to 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 su tractors, on work to performed un4er this Remarks.. ..... ( Signed) 4 0 41/ ' permit, as are licensed by Miami Shores Village. My Commission Expires NING BOARD_ DATE Member Member Member . _Date Disapproved -- STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly auth orized to administer oaths and take acknowledgments, personally ap- peared to me well Imown, 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 e. Permit No Date Read, Sworn to and Subscribed before me. - Notary Public, State of Florida ...... Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has horn 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 inspe, tion or faulty materials and/or workmanship. 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 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. t .. r //:/ Owner's Name and Address __.- , _ - 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) STATE OF FLORIDA, COUNTY OF DADE. (Signed) }ss. Date No f r Street and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind foundation �, Estimated Total cost of improvements $ � " : � Amount of Permit $ 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 such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors y on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) 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 a is the of the above described construction, that he h ul read the fore ing application, and that he did sign the same, and that all facts therein by him st t are true. 1 S ."'" Permit No.__�_�__= Date 1 d, Sworn to and Subscribed before me. Disapproved , Date Notary Public, State of Florida Building Ins eetof Commission Expires PLANNING BOARD___,' DATE Chairman 0. Methber 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 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.