1279 NE 97 St (3)Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done / Cif
New Building Remodeling Addition
To be constru
___ Kind of foundation
Estimated Total cost of improvements $ /a®
Zone cubage required
Distance to next nearest building
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Building Inspector
Chairman
Member
Member
Council Approved Date
NOTE: A charge of $1.00 will be made for making
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
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, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date
Owner's Name and Address °' ' No e 7 Street.J&
Registered Architect and /or Engineer ___
Name and address of licensed contractor. ^ /C S
AVV✓/✓6-
State work to be done and purpose of building (by floors)
epairs
PLANNING BOARD DATE
and for no other purpose.
No of Stories
Roof Covering
,VC.
O• Jo
Notary Public, State of Florida
19 SY'
Amount of Permit $
.Plan Cubage
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 work to be performed under this permit; and will post or cause to be posted for ' . on on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such s ' <� o work p be performed under this
permit, as are licensed by Miami Shores Village. m
Remarks (Signed)
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 l/ Date__S, Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
My Commission Expires
Member
Member
Member
Disapproved Date
corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
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 .ecifid 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 work to be done and purpose of building (by floors)
GA Gcm/6-
New Building
To be constructed
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date
No Street
Registered Architect and /or Engineer
Name and address of licensed contraot _ a( /4 044 �,
Location and legal description of lot to be built on:
Lot Block p Subdivisi n
Street and Number where work is to be done // � .-
Mode ' Addition Repairs ° No. of Stories
v7 m foundation Roo Coverin
7 %') ��
Estimated Total cost of improvements $ Amount of Permit $ a c:Y1
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 5968, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance froin_alLcontractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted f.. i.s echo the site the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such sub to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
, 19
and For no other purpose.
STATE OF FLORIDA,
COUNTY OF DADE. J ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgrnents, 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 sane, and that all facts
therein by him stated are true.
Date Read, Sworn to and Subscribed before me.
Permit No
Disapproved , - \ Date
Notary Public, State of Florida
—
( Signed)
p$din Aspector 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.