1286 NE 96 St (3)r
Application is hereby made for the approval of the detailed stateuu•nt ur 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 wit t, 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 (ljtzCten. C u nit
Registered Architect and /or Engineer
7357 N Ul. l�Iiun'��t �.... !'� 31
Name and address of licensed contractor Obt?noua Roo
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done
State work to be done and purpose of buildi
4ect2.on and 1 1 bu. .
STATE OF FLORIDA, 1
COUNTY OF DADE. j ss.
APPLICATION FOR BUILDING PERMIT
Disapproved » _.l ,./Date. , nr —
(Signed)
MIAMI SHORES VILLAGE
Building Inspector
BUILDING INSPECTION DEPARTMENT
/286Sh iv ,(.ion9
refut stung .& wo7cn . on alopcng
(by floors .... _
rY' °iy _.._.._ and gnave.L on sec .i one
_ fticuch /8 _ _ 82
Date..._..._... ..�. _ . _ . ,19..
— No... ??...( .._. street l � . .26th 5 .
11.12 ttt•• •t,f•!, ttlMHttt,t.!•tt
_.__... ........and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation rfb5rring 346) _..__
Estimated Total cost of improvements $ 7 :5 Amount of Permit $ _.....
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 wi h 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 w ith the p rovisions thereof, and will require similar compliance form all contractors or sub - contractors eat loyed by hint
in the work to be performed under this permit; and will post or cause to be posted f 31 inspe n on the site of the work public notice
or notices as arc required by the Act. The undersigned agrees to employ only s s a.-aa actors, on work to . »pey ed under this
permit, as are licensed by Miami Shores Village.
Remarks (Sig .0) e .1
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared_._ . _ ° –
._....to me well !mown,
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. a 3 .z. 3 Dee `��� 9 y Read, Swor,t to and Subscribed before me.
Notary Public, State of Florida
My Commi ision 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 Pl.rnnir.g 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 anti /or workmanship.
MIAMI SHORES VILLAGE
BUILDIN INSPECTION DEPARTMEN
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the det.. iled statemen of the plar s and specificw ions herewith submitted for the build-
ing or o h ructure her i described This rplicatic is made in compliance and con o'rn ty w.th the Building Ordinance of Mia
Shores Villatie, or da, and all pro isions of the Laws c f the State of krid. all o d nances f Mi ni Shores Village and all rules and
regu a ion, of the Building Div.. i of .iain Shm illage '1 ,e ipl.ed with, whether herein specified or not. A copy of approved
plans and specificati , n- must be km . at building durin progress of tl.e wcrk.
Date 7/ 1 /5 1, , 19
Owner' Name and Address Blain No 1 ?Ftrl
Street •'-‘J •
Registered Architect and/or Engineer. J, 1./tr?
Name nd address of licemed contractor. in no' .R.00.f.1ng rcl Tile Co ., I nc. .3r7 F . 7 n
Location and legal description of lot to be built on
Lot Block Subdivision
Street and Number where work is to be done 1 r T. 96 i;
State work to be done and purpose of building (by floors)
. and for no other purpose.
New Building X Remodeling_ Addition__ _.__ ..... _ Repairs. . NolliStories
To be constructed of_ _ _ Kind of foundation . Roof Coy ring__ 3 t
Estimated 7 -,tal cost of improvements $__ A 75.00 Amount of. Permi: $._ 5.
Zone -ubage required. _ __Plan Cubage
Distance to next nearest building__ _ _ Size of Building 1..ot
Maximum live load to be borne by each floor _ . -----
hereby submit all the plans and speciiieations for said building. All notices with :eference to the building and its construction may
be sent to _ _ _ _
The unde signed appli ant for th's building permit does hereby certify Ciat he undcrctands and accepts his ...bligations as an employer
of 1 bor under he Florida Workmen's Compensation Act being S—tion 5966 Cm p le El Gen al Laws of Florida P r anon S.tpplc 'lent,
and 11 s compl ed w:th he prov'aons thereof, and will require s.milar COMP lance from all contractors or sub-contractors emplo .ed by him
in the wo k to be p rf med under th s peni it and ill post or cause to be posted for i ispection on the site of the work su :h public noti e
or •otices as are requir d by the Act. The u. d. r ign -d agrees to employ only such abcontr. ctors, on work to be .perforn, d der this
permit as are licensed by M am. Shores \ ge. DM' c Reofinz Ti1.3 I.
Remarks. (Signed) //.4t-iriee
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths .nd take acknowledgments, personally op-
peared _
to me well lcnown,
and who, being by me first d. ly cworn, upon oath deposes and says that he is the
of th abov de .c ibed • struction t, • h has carefally read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are tr se.
Permit No 2. Date_ . /6 - Read, Sworn to and Subscribed before me.
Disapproved Date _
-\\ Notary Public State of Florida
(Signed)
Building Ins . My Com:nissior 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 Ifter approval h is been obtained from
the Planr ng Board
A re-inspection fee of $1.00 will be charged when such re-inspection is rn...ie neces:a:3 by improper notice for inspe:.Pap or fa Ity
materials and/or workmanship.