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12 NE 96 St�l ` je7 � ' °*(1/ t MIAMI SHORES VILLAGE Permit No Disapproved (Signed) Building Inspector NOTE: A charge of $1.00 will be made for the 1'lannin;; hoard. A re- inspection fee of $1.00 will be charged materials anti /or workmanship. BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby mode for the approval of the detailed statement vt tau 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 'budding during progress of the work. /� / • Date..._. ._ � Owner's Name and Address 1 :[. / .... L� . Hp-� ._ � r� �G...11�� 6 &S No. .. _ Street 9 �0 - Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot..../ GC/Le ...Ll........ Block Subdiv Sion... APT . Street and Number where work is to be done. ... E • ` __...._.._.... _�. . ...._ .� _... M State work to be done and purposo of building (by floors)... L,d1. ' Date 1 4 ■ Date Chair :ran \Icrnber Member ...__....._..._._ .._._..... Council Approved Date and for no other purpose. New Building Remodeling Addition Repairs No. of Stories — To be constructed of Kind of f undation.... A Roo f overing Estimated Total cost of improvements $ I 7 5. 0 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 59G6, 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 ntractors, on work be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed STATE OF FLORIDA, COUNTY OF DADE. j s '' 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 sta e ; _ e. 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 • 4o C ° 2 m ,i M m H -I O O 0 m m d T - C m m m n 2 m 3 N W M CO r 2 m O O A 0 O _M m v Co p 1 = D o D D m -1 .. N r • n e "/ 3 C m ...4 A C y 2 N n O * ti 2 -/ - O m X = m - ). 2 .. S > A N m C i m O O m c. m N m Z 2 O - ° I ° n m v 2 y 2 _ 0 n O = ). A C m m • CO 2 0 . O > 2 1 `G 13� tJG�{Z'1Ja : 4 • I f • j 3 i 1< '• Y +1 .j,.. •t 1 horsey certify that the attached sketch represents i recent survey mode under my direction, and Is true - and correct to the best of my knowledge and belief. and that the>•e are no .n -- croachments on said lend - other are shown�ere- en. /ear'• 1./; `4-- 01441-7A" FI., egg. Surveyor Wo:))9 Fie. Meg. gnomes/ Pls. /P72 DAT This property described as: 'Lots 10 and 11, Block 5, AN AMENDED PLAT OF MIAMI SHORES NO. 1, according to the Plat thereof, as recorded in Plat Book 10, Page 70 of the Public Records of Dade County, Florida. �. L . �� • 4 . 1 301 J 2:91: .yf" 1 •14 P OP UTy of : Riggs, 12 NE 96th Street'; Miami' Shores,. Florida. P. O. Rom 661131 Ple.ldi. 31111 A(. E DAMN PI LANNES end GARCIA, INC. ENGINE s - LAND sum/routs- LAND PLANNEes Dew°. NO. 178 -4361 THESE PLANS ARE APPROVED FOR ISSUANCE OF A BUILDING PERMIT VARIANCE(S) LISTED IN "REMARKS" MIAMI SHORES BUILDING AND ZONING UNLESS SPECIFICALLY LISTED BELOW. 1 AND COUNTY LAWS MUST BE COMPLIED Authoriieri Signature Date • WITH NO VARIANCES • WITH NO OTHER DEVIATIONS FROM THE ORDINANCES WILL BE PERMITTED, ALL OTHER APPLICABLE STATE WITH BY ALL PARTIES. FIRE DEPARTMENT PUBLIC WORKS POLICE DEPARTMENT • a BUILDING DIRECTOR \\ V TVA I 4101*; PLANNING & ZONING BOAlw VILLAGE COUNCIL APPROVAL PRELIMINARY: FINAL: REMARKS: COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED BY MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER & SUB CONTRACTORS ARE CP'Rt'F!; v!rr :i ,.,.. Ica,'!IEME (IF AIJ riu,L©- !NG REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIIt