1122 NE 97 St (3)V L LA E
BUILDING INS- ~EC:TION DEPARTMENT
AP LI TI®N FUR j 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.
Date , 19
Owner's Name and Address 1=, �� '� No ' Street
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)
•
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of I {ind 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 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 subcor�,traeto�s, on work. to be performed under this
permit, as are licensed by Miami Shores Village. ;l c�'
Remarks---- (Signed) ti��( ^s r,
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 / /1 () t ' ` Date / ,) ` / Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed) �� ' �
uilding Inspector My Commission Expires
Notary Public, State of Florida
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.
\t ,
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement vs Isle plans and specifications herewith submitted for the build •
inc 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... .. ...11� — _......_ — ...19.. — .:i
Owner's Name and Address .... .0
. ..n.... 4 . 4�;.
. .a..c_. ...� .. e.0 `:.,_ _ No.i.� . _
. ... Street_.._ L i _ . _-.
Registered Architect and /or Engineer.... V ..b d p k 4 .L a :•5+: 4-e , 1 „..,. n.••• ,,.,er.nner «ae• ore..
Name and address of licensed contractor... b.C1t.?. (C..:.Ck. _.41.... ..C�...tf3.. ®.. ._.....3cf.. 5 _ ... ) _() - :
Location and legal description of lot to be built on:
Lo 4.: - Block I.C.. - Subdivision .......ww ..._ — .........
..
Street and Number where work is to 'be doe f.t ;La C o
State work to be done and purpose of buildin
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
_ 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 $ r°2 a Amount of Permit e
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 Supftleinent,
and has complied .. ith the provisions thereof, and will require similar compliance from all contrac -.rs or sub - contractors employed by him
in the. wor to be performed under this permit; and will post or cause to be posted for ink ectio the site of the work such public nosicej
or notices as are required by the Act. The undersigned agrees to employ only such subeo tra rs, on work to be performed Wader this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
SS.
Disapproved t ; .. Date
uilding Inspector
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..__� r% 1�.f Date 8.�.).1.fe 1....._._._ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
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 fmm
the Planning Board.
A re- inspection Ice of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
PLANNING BOARD AGENDA OF [40\MMO Zi4 SI ITEM NO.
Gov aw, kbeio 9
Name of Owner /Applicant Mee crf4 Phone No.
Address of Property, and /or Legal Description QQiZ V- 91 9
Nature of Request NO ? ‘9 ^!� `� VtAb% WJ *®b
Present Zoning t•—
Area of Present Building
Area with Proposed Addition
Parking Spaces Provided
aiami cfhores9 llage
F L O R D A
Parking Spaces Required with Addition
Setbacks as per Code
Setbacks Provided
Variances /Exceptions /Zoning Change
50 0 wre A WaiVi / ® ®(V'
d ;,' A ) '
Council Action
Council Action Required
Date of Applicant Notification
Planning Board Action Wit 101h1
Nct
Director of Building and Zoning
STATE OF FLORIDA,
COUNTY OF DADE.
SS.
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING `'ERMIT
Application is hereby wade for the approval of the detailed statement ur 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.
Owner's Name and Address ..uJ.' CALA,A., ° U u �Cr .0 � 1�,_._ NoLit:kel,
Registered Architect and /or Engineer A ( .
A,4"
a .
ti1 ti+ o
`amt and address of licensed contractor. :_. .� :.s. 1 .: 1\....,:,.A, a.t 4` :.��:... -..N : . -.,.. ....�.:iv.:. a._`'..... =�
State work to be done and purpose of building (by floors).....__E...e..VI—Ca. % tr 4._...c.,.1
�
" and for no other purpose.
New Bui!ding Remodeling Addition V Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ °`— Amount of Permit 5... ..x.0}0
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, Prominent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all coOractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for i spection on the site of-the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such spa ' ntiractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. ,
Rem uks (Signed) / 1( ` oa- V r - \
u
7.
// G
Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments. personally ap-
peared
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.. IA j p� Date 9 4 D Read, Sworn to and Subscribed before me.
Disapproved. ` ..:.�� . Date
Notary Public, State of Florida
(Signed)
My Commission Expires
to me well known,
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 Pl.innir,;; Board.
A re.in.pcction fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials anti /or workmanship.