1249 NE 97 St (9)Alpo MIAMI SHORES VILLAGE
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, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
-, 1
Date ✓ , 19
Owner's Name and Address
Registered Architect and /or Engineer Z r_1__L ' r
Name and address of licensed contractor ' ,__.t___.�_!
• o,
Street and Number where work is to be done ; t
BUILDING INSPECTION DEPARTMENT
Location and legal deyhription of lot to be built on:
Lot_t_ __� i r'�?t__ __ Block %. Subdivision
,/
No Street
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 i Kind of foundation_____ ___ Roof Covering
Q _ _71 p 'a
Estimated Total cost of improvements $___":2._2 " ___Amount of Permit $ �
Zone cubage required �'_� plan Cubage 2. 1 __51.0_
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 1?y 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 4uch ub1ic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be per rme under this
permit, as are licensed by Miami Shores Village. i
Remarks (Signed)
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 true.
Permit No v Date
Disapproved Date
(Signed)
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector 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 i:spection or faulty
materials and /or workmanship.
1 4 ,
Owner's Name and Address \ a r i
Registered Architect and /or Engineer
Name and address of licensed contractor
Estimated Total cost of improvements $ `� __
Maximum live load to be borne by each floc
Disapproved Date
( Signed)
MIAMI
BUILDING INSPECTION G_
APPLICATION FOR BUILDING T.RMIT
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.
Location and legal descr tion of lot to be built bn:
1
Lot � • < <-- _ } -.:� Block Subdivision 'i � l t j G=
Street and Number where wed( is to be done
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stones._ 1
To be constructed of. ____.- '— :., Kind of foundation + _ _. /' Roof Covering 1 ___i
�7
Amount of Permit $ 2,, c c e: . .
a required G _ �___�__x .' :__�i__
Zone tuba
g q _Plan Cubage
_Size of Building Lot 7s
Distance to next nearest building
--- °.-L 4^
•
Date
, 19
Street
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
Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved __ Date Disapproved
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 pf the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work )t be performed under this
permit, as are licensed by Miami Shores Village. ,
Remarks (Signed)
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 true.
Permit No. Date Read, Sworn to and Subscribed before me.
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.