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1098 NE 96 St (3)4 Disapproved .. (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement ur me 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 bc kept at building during progress of the work. Date..._......_... —� _..._.__.. ,19.. Owner's Name and Addjf,ss . : / '2.ir2 — No. 10 22 Street .. 5 . Registered Architect and /or Engineer ,f f Name and address of licensed contractor.. .AC.4 LCW. :. �� :8�,l -• •N• — t : /z•< • s Location and legal description of lot to bbuilt on: CC —, L / Block Subdivision 72/ SE/-/ 3 _LI ?e Date ., :.. ...• ••,,,• r r..n... rn.-.- .n...., en-tit Street and Number where work is to be done State wor to d ne and purpose of building (by floors) -- ••- •• -••. _ .. f ) . -5 lam tors? ©f Z — a._. r . ,7.L , 1.. -•..- -. /— 0 7�".r. c. � .. . (� C. - v e? x5e.fee e el / 7 R f @ ' c�-'c + O r/C . A 0 - 7, 5klr1 . .0. f GS. and for no other purpose Ncw Building Remodeling Addition Repairs No. of Stories _ Roof Covering To be constructed of Kind of foundation Estimated Total cost of improvements $ , - Amount of Permit L. .�N 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 pertnit 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 Keith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to bc 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this d Miami Shores Vi permit, as are license b y a tamt ores ll Village. I �/! Remarks (Signed)` ez.wiX:f .1/. .. Poboae = .6..6 14-2e STATE OF FLORIDA, COUNTY OF DADE. I 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 him stated Permit No.._ _._ Date.... � � Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Citair:nan 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 I'iannir .t Board. A re in'pec•tion fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship. rY1 Pryvl fl-okr:_qc -- gLA,(09L, / kv (LAS ll I c„,.cf2,K, au` in 6 ,06 o e 4+ 2- ` 177o e 965 nL�� f - 1 - 6« (0-eft- Owner's Name and . Address /� • 'r Disapproved (Signed) Citair.n•rn Mfcrr,ber Member .. Council Approved Date NOTE: A ch.rrge of $1.00 will be made for the PI. nnir,;; Board. A re- inspection fee of $1.00 will be charged materials anti /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement ur we 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 tltc 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 bc complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. i . ...... ... .............. Registered Architect and /or Engineer.... • • ••• Oh- Name and address of licensed contractor Location and legal description of lot to be built on: Lot 1 Block Building Inspector 1 74 - 6 "alp -7 ' An*. C ilj _ No....! oqY..__. Street_. / e gb 121 ... -717 sfiee Subdivision /- I� Street and Number where work is to be done 1.O 63' ?_ - State work to be done and purpose of building (by floors) 00 Ake.. -- and for no other purpose. Addition Repairs No. of Stories New Building Remodeling To be constructed of Kind of foundation Roof C Estimated Total cost of improvements $ /S t�•0 Amount of Permit S..... 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 eeith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to bc performed under this permit; and will post or cause to be posted for insp ction on the site of the work such public notice or notices as arc required by the Act. The undersigned agrees to employ only such subco 'actors, on work to be performed under this pennit, as are licensed by Miami Shores Village. Remarks 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 scanted are true.. yy�� Permit No.._..:l..L 1.L Date. Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Member Member Member — .._._... Disapproved Date making corrections or changes to this application after approval has been obtained from when such re inspection is made necessary by improper notice for inspection or faulty