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1201 NE 97 St (4),�. 4 c >- ; • e • • STATE OF FLORIDA, COUNTY OF DADE. ss. 1' MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING 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, whet, rein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date G dJo J „ , 19_ / Owner's Name and Address. lvd 'cl S� No Street Registered Architect and /or Engineer F ee ° Name and address of licensed contractor D o e•d ' ' w Jv Location and legal description of lot to be built on: Lot � Block Subdivision_ Street and Number where work is to be done Disapprov 4 Date Buildin•/ spector State work to be done and purpose of building (by floors)____ _ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of -"- d ___ Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required ____flan Cubage_TU 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 with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the or to be required d uired by the Act. The will agrees to employ only ub subcontractors, of under the ... notice this permit, as are licensed by Miami Shores Village. Remarks ( Sign 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� tated are true. Permit No Y ? - -- Date 0- 2 '(,/ Read, Sworn to and Subscribed before me. Notary Public, State of Florida 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. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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. Date / r/ 19 � Owner's Name and Address .S� a/ 43,e mc No. /2-01 Street AC 9 ? i Registered Architect and/or Engineer 4 61/0 C-4 / Name and address of licensed contractor �f1 C&VST/? 0c., 1 - 1 De .,2 / ? e • ' 4'i'1 9S klee Location and legal description of lot to be built on: A - OS O 9 ro ,57,' Lot fl Block 3 Subdivision e 77K/ S &'� Street and Number where work is to be done / 2 / � 9 7 .S I Aid/ / State work to be done ana purpose of building (by floors), state exterior colors (submit samples) 6'T�'�'" i i4 04/ - /3,0 irk /7VV-0l< .goo #i9 geftwzn &- s0.7./ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories pp To be constructed of Kind of foundation Roof Covering Ceevl '9`r 0 Estimated Total cost of improvements S SO, Amount of Permit S 1 Zone cubage required Plan Cubage r � Distance to next nearest building Size of Building Lot 1 kl Maximum live load to be borne by each floor I hereby submit all 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 obligatons 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 (Signed) �� c 4 under this permit, as are licensed by Miami Shores Village. Remarks C STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. Permit No. Disapproved (Signed) Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Date fi Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 S25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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. Owner's Name and Address STATE OF FLORIDA COUNTY OF DADE. } ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Registered Architect anchor Engineer �i �� G j Name and address of licensed contractor q 1- f 0 ��{ N C / � )y /2 Z,'-�! ,fl Location and legal description of lot to be built on: n Lot v / Block Street and Number where work is to be done ' •^// State work to be done and purpose of buildint (by floors), state exterior colors (submit samples) G.— — I '� %!�� /- �U Y' 4 r • New Building Remodeling Remarks (Signed) c, Subdivision Addition 19 J / .� No. ./ / Street___ 2 J2 Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements S i Amount of Permit S ,f, Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot 1V..aximum live load to be borne by each floor I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to 49, Permit No. i ` Date Read. Sworn to and Subscribed before me. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 ccmpliance 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 subcon rectors. on work to be performed under this permit. as are licensed by Miami Shores Village. /3J Before me. the undersigned authority, a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared 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. Disapproved ir Date Notary Public. State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE and for no other purpose to me well known. Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of 525.00 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 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship.