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1026 NE 97 Stt�J 41tom .: PLICATION FOR BUILDING PERMIT Applica or other str Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regula- tions 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. STATE OF FLORIDA, COUNTY OF DADE. Q MIAMI SHORES VILLAGE UILDING INSPECTION DEPARTMENT y`made for the approval of the detailed statement of the plans and specifications herewith submitted for the building erein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Building Inspector PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved .Date Disapproved l� .� Date__ -- - , 19 b Ownei s Name and Address E r- No._ —;� Street — .� A Registered Architect and /or Engineer Pa4-1 Y�i Srb.,e2.�.J�OO 1 .rch .tect� 1756 1'T • .1• 2 rd -.t • Name and address of licensed contractor ,,' , ; ' , a, , Iii1A-71;7 r - a• 1�' > Location and legal description of lot to be built on: Lot 10 Block__ 1 8 1 _ _ Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) chores 6ection 8 ___ - ,- _- _----- - ___ -_ -_ -- —___ —____ and for no other purpose. New Building ------ _ ^________ Remodeling________________ Addition________________ Repairs No. of Stories_____—______ To be constructed of___G a_______ Kind of foundation_C • vx'Cia.d`ootirf'; oof Covering Cell" ShiNil 6 r.:' i]. Estimated Total cost of improvements $ T -� 1 `_';_ Amount of Permit $___ -- _.- Zone cubage required r 5� Co Plan Cubage / ,- J Distance to next nearest building_____________________— ______-Size of Building Lot 7 t Maximum live load to be borne by each floor AO -s I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to_�l�sT• 1A! + 1.Ilt lV A - The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit: and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon actors, on wog to be performed under this permit, as are licensed by Miami Shores Village. �_ Remarks (Signed) Before me, t undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 7.,E. Es TES ,y' 70 and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has f lly read the foregoing application, and that be did sign the samq, and that all facts 'jy . therein by him stated are true. /9 Read, worn to and ubscri bed before me. Permit No.__ Date' Disapproved — — — — - Date � (Signed) to me well known, N Vary Qwy1+¢, PStdtc, <Sf. >felarfd$ ride e+ l.VA& My commission expires Merck 9, r My Commission Ekiriet la Amocir• Cyr Co. -o #. -X.- —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. pk. tZgl 1 S'S ob. 1 " e ? 1 ' 4yt x s s 32.../y to' 6" ZJG" 1C aZ. `a " 3 (Ks .0 ic 3 Let 18 to $1714, o , 1 ,© ✓49 n 4S I IGoo 2 effr 0.50 ` "t 2 S8 �, 16 ,L2. , 4'j3 L, 3 . I G'7 t(.3s' ti �8a food ,*•)7SS _ I =- 3, I