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1131 NE 97 St_ Distance to next nearest building STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT ,TION FOR BUILDING PERM al of the detailed statement of the plans and specifications herewith submitted for the build - pplication is made in compliance and conformity with the Building Ordinance of Miami ie Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and Shores Village shall be complied with, whether herein spec, Pied or not. A copy of approved ng during progress of the work. g (by floors) on: Air 7St f,. /a/ ' Subdivision__.________ /- Remarks (Signed) ____ Street____, n _ _ �� � _' �� and for no other purpose. New Building /- ...,./Remodeling Add.4fipn Repairs No. of Stories__._ To be constructed of l ;, . Kind of foundation - �' ` Roof Covering Estimated Total cost of improvements $____.:___l_ Amount of Permit $ !� Zone cubage required_____ >._.� �_' _ _Plan Cubage Size of Building Lot 2 - / � / Maximum live load to be borne by each floor *% J I hereby submit all the plans and specifications, for said building. All notices with- s¢ference to the building and its construction may be sent to ___ / �� i ✓ 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. 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 tr - ,- >� Permit No / ___ '__ )Read, Sworn to and Subscribed before me. Date____ Disapproved Date Notary Public, State of Florida , ( Signed) ' � - Building Inspector 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. , C,A; A A, " ) , ) 4 - �rc1 e t c t Plot thereof as re ord Lords of ,A cl tlr '1c ric i NEAFA1i CERTIFY t }ot thr nttcrhr u atuvey , dirrcti, ',,otnd, it '; t. <<nd correct tb thr 1 rf rn. . cnd br - Thrre nre tln "antrotf{,4r •:1 i }. Y�'`t t pq �h 4.yvlL a• RFCr:S7 .C$ LAND „it ilV,;(0Ft r) STAtF.:QV ."LQRW B.FOD * 1714S. W. 1st Street Miami 35, Florida TelQpfio 9 -3568 .