1201 NE 96 St (8)c
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MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby umdc for the approval of the detailed statement ur cne plans and specifications herewith submitted for the build •
inc 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 prpgreu of the work.
. /
Date...
CI.: -Z 1 —.--- _... ,19t�1.�
Owner's Name and Address . . • S ...17 E S . l.Z0.1.N . ... r No../ ..?:-.0,../—. Street_._. – Ca. _57
Registered Architect and /or Engineer cccc. ,,.•••,,.•:, .,,.,,,,,.,..•„ x,-„
Name and address of licensed contractor /Z C.e.. -. C„.. 'a U 43 Sc✓... - • . 57-
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Location and legal description of lot to be built on:
Lot Block !S1 Subdivisions ' E. g� .. _ ._..
Street and Number where work is to be done / ?r 0 l ...2 s1. __ — ... __ ..�
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State work to be done and purpose of building (by floors)..l.L..5.,T..'11.. &•.7 / v t O _?.., .�.<. A _L__
Building Inspector
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer
and for no other purpose.
Ncw Building Remodeling Addition Repairs No of Stories
To be constructed of Kind of foundation Roof Covering
Estimate Total cost of improvements $ •• Amount of Permit $.5 u v
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 Snp pleurent,
anti 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 ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perf • .•• this
perrnit, as are licensed by Miami Shores Village.
Remarks (Signed)
FE X f c I S c 0
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 true.
Date / (y
Y/ T ~ Read, Sworn to and Subscribed before me.
t
Disapproved Date
Notary Public, State of Florida
(Signed)
My Commiuion Expires — ..._ .._.—
PLANNING BOARD DATE
Chairman Member
\1crr,bcr 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'Lrnnir.g Board.
A re- in.pec-tion fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty
materials anti /or workmanship.
June 2, 1982
I do not object to air - conditioning units installed on the
east side of residence at 1201 N.E. 96th Street.
G. Ware Cornell
1209 N.E. 96th Street
Miami Shores, Florida 33138