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.
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B.FOD
* 1714S. W. 1st Street
Miami 35, Florida
TelQpfio 9 -3568 .