1249 NE 97 St (10)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 JOHN LOSAK == 274 - 7781 = == 124
Registered Architect and/or Engineer
SECURITY WINDOWS. 5100 N.W. 72 AVE. MIAMI, FLORIDA 33166
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot 1 - Block <3
Street and Number where work is to be done
under this permit, as are licensed by Miami Shores Village.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
i•' i - - ' - n=
Subdivisionfl l "2 aFlrYl�
State work to be done and purpose of building (by floors), state exterior colors (submit samples)
REPLACING 36 JAL WDWS AND 4 P/W WITH 36 ATW AND 4 P
• CHANGES.
•
IP
New Building Remodeling
7b be constructed of Kind of foundation Roof Covering
Amount of Permit 8 q l e
Estimated Total cost of improvements $ 7000.00
Zone cubage required
Distance to next nearest building
Maximum live Toad to be borne by each floor
1 hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to
Plan Cubage
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 agre to employ only su trasl s,on work to he performed
Remarks (Signed)
Permit No.
Disapproved
(Signed)
Building Inspector
Date
u �t
.•
Size of Building Lot
D ate DECEMBER 6, 1990 14
PIs &RIDA .
1249 N.E. 97 STREET MIAMI SHORES, FLORIDA.
Addition Repairs_ No. of Stories
PLANNING BOARD DATE
U-CTURAL
and for no other purpose.
SEYMOUR GOTH ELF
CBC 9454 (J' =
STATE OF FLORIDA
COUNTY OF DADE. } ss'
Before me, the undersi ed authority, a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared
S �— +,m0,..•(t., (' t\ _ to me well known.
and who. being by me first duly sworn, upon oath deposes and says that he is the IZVJAW
of the above described j 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.
Q / / °/ Date / ` Read. SwotfT and Subscribed before me.
` /
Notary Public. State of Florida
COTARY PUBLIC STATE OF FLORIDA
My Commission Expires ptv cnnuTSSI0i1 EXP JULY 25 1991 •
BOLDED THRU GENERAL INS. UND.
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.