1025 NE 97 StTo be constructed of e'g•
\4 cman
• MIAMI SH®RES VILLAG
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PE IT
,y made for the approval of the detailed statement of the plans and specifications herewith submitted for the build -
Lerein described. This application is made in compliance and conformity with the Building Ordinance of Miami
, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
ltding Division of Miami Shores Village shall_be complied with, whether herein specified or not. A copy of approved
.ions must be kept at building during progress of the work.
Owner's Name and Address_ _ __ ___ .
Registered Architect and /or gineer
Name and address of licensed contra tor . go. - ¢ -
Location and legal description of lot to be bu
Lot � Block in-t Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors) ______S Q._
New Building Remodeling
Disapproved ( Signed)
Builds g Inspecto
Date
t° d 1.J.Lia , 19
No. _,7Q Street__ t ' _ 7
,v-
dition
/1/,4-
Nyed Date Disapproved
igtot a044.4.0 ,4z2. 60,
and for no other purpose.
Kind of foundatio
Repairs No. H of .Stories ,q
/ Roo Govering_- BBL-1.�C7 s- - _
Estimated Total cost of improvements $____ /'l f Q__O' Amount of Permit $
Zone cubage required Plan Cubage 4 Z- '
C
Distance to next nearest building ______2 0 r = to__ _ " Size of Building Lot 7_ a? r
/ 2c _____/ / c_c_
Maximum live load to be borne by each floor
I hereby submit all the plans and pecifications for said building. All notices with reference 'to the building and its construction may
be sent to ,•
The un signed applica t for its building permit does hereby certify that he understands d accepts his obli . as an employe-
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gene l Laws of Flor'.a 'erm. ent Suppleme
and has complied with the provisions thereof, and will require similar compliance from all co actors or ..'co acto : employed by h
in the work to be performed under this permit; and will post or cause to be poste spe 'on on s o e . such public n. -
or notices as are required by the Act. The undersigned agrees to employ only suc sub ntractors, yoy i .e performed under t4
permit, as are licensed by Miami Shores Village.
Remarks---_------_ _________ - ---------- ----- -------- ---------------- ------------- - - - -- (Signed)
PLANNING BOA DATE
Member
Member
Member
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 e first duly sworn, on oath deposes and says that he is the
of the above descr ed construction, that has carefu y read the foregoing application, and that he did sign the same, and that all facts
therein by him sta d are true. r°* .c "'
Permit No 1_.__ _ _ __i '_� Date _ _ _ i. ad, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
_Date
urge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
anship