1196 NE 97 St (12)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 budding during progress of the work.
Owner's Name and Address ... .. ...... P .. 6: .. . I N J L «L.�1 _ ._._ ._ No../ L'2 LL...... Street-1 :..�1 �! 7 •
Registered Architect and /or Engineer , -, ._,,..,,,,,,,. „.saes„,
Name and address of licensed contractor C ' -' ^ ft
Location and legal description of lot to be built on:
Lot 1. Block I Si. I
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Disapproved
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
Subdivision Y L!se. P � C4 cle
Street and Number where work is to be done (1 c l /~ `i. _.S
State work to be done and purpose of building (by floors )..._bast 1 ' Q. v - C e
\L-e C r \
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of IOC'eck Kind of foundation y Roof Covering
Estimated Total cost of improvements $ C; O 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 - ...CG_b;_ t: C
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.
Remarks (Signed)
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 � ” Date..
Read, Sworn to and Subscribed before me.
I -
_ LEI IG:Lb11
to me well known,
-- Date.._....
( �� f � Notary Public, State of Florida
B uildi nspector� ` �. Commission Expires _ _
PLA NINC BOARD DATE
Chairman Member
Member Member
Member sass.. 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.
Owner's Name and Address
Registered Architect and /or Engineer _
Name and address of licensed contractor___ .
Location and legal description of lot to be built on:
Lot _..___ /___ Block / V Subdivision
Street and Number where work is to be done .__._ / 9 ________
State work to be done and purpose of building (by floors)
New Building Remodeling
To be constructed of Kind of foundation
Estimated Total cost of improvements $_._ e 00
Zone cubage required
Distance to next nearest building.
Maximum live load to be borne by each floor
Chairman
Member
Member .
Council Approved
e
Disapproved
(Signed)
MIAMI SHORES VILLA E
UILDING INSPECTION DEPART ENT
(Signed)
APPLICATION FOk c:.:,",DING 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.
Amount of Permit $
plan Cubage
Size of Building Lot
and for no other purpose.
Addition Repairs No. of Stories
Roof Covering
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 Flo 'da, Permanent Sup lenient,
and has complied with the provisions thereof, and will require similar compliance from all contractors o sub ntractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection o the sit:. , the work such ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcon.: ct. 7� ''w. 4. be performe under this
permit, 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 stated are
Permit No._ !L_� Data u 7,-7D Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Ins My Commission Expires
ANNING BOARD__ __ . DATE
Member
Member
Member
_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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
•