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294 NE 97 St (2)Owner's Name and Address Remarks STATE OF FLORIDA CuvNTY OF DADE. MIAMI SHORES VILLAGE BUILDING 1NSPECTION 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 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 / ~ /0 f -r A 19 No. J d� 1 y Street V f 2 7 St 4 1o1etAjgc gineer f ? Qzi /4:4 ) ) _ (� Q Name and address of licensed contractor $ c 1 e A 0 mo� 5 L o AL c L c:f , Location and legal description of lot to be built on: // � a d 6 /5 0 Lot_( �J Block 21D Subdivision 6 / \ /VN ` o r -e z - e'ci Gd Street and Number where work is to be done 2 v _ `._7 // °� State work to be done and purpose of building tby floors), state exterior colors (submit samplesl� Q brie` �/ VV � Cv d e ev= inotiet ES__10 w i t , / O 5-e'er — U1 New Building Itemodeling_ � Addition Repairs To be constructed of e. C_ ./. (* __ ndferfrdation Roof Covering Estimated Tr■tal cost of improvements $ 29 7 04' Amount of Permit 5 \ Dondad rhru 1 rc 1"4 - Insarunce, Ia . No. of Stories Zone cubage required __ Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load 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 __ —._ d 44Q„ e-v and for no other purpose. 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 \Vorkmen'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 r. '.use to be rusted 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 . subcontractors. on wrrk to e permed under this permit. as are licensed by Miami Shores Village. 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. r i Permit No. � % � �� . Date l 42 Fe Read, Sworn to and Subscribed before me. Disapproved (Signed) Chairman Member Member _ Council Approved Date Building Inspector My Commission Expires PLANNING BOARD DATE Member Member Member Date Disapproved Notary Public. State of Florida Date NOTE: A charge of 825.00 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 825.00 will he charged when such re- inspection is made necessary by improper notice for inspection or faulty 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 speci ' ations must be kept at building during progress of the work. New Building To be constructed of Estimated Total cost of Disapproved (Signed) ��� Owner's Nrfine and Address Registered Architect and /or AE ineer Name and address of licensed contractor and legal description of lot to be built on: Lot Block Street and Number where work is to be done____ 9 State work to be done and purpose of building (by floors)_ therein by him stated are true. Permit „I_ _ -_ Date ° ° ) and for no other purpose. Remodeling Addition Repairs No. of Stories f Kind of foundation Roof Covering improvements $___ e't Amount of Permit $ Ste; 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 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contr ctors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspe ion n the site of t work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon actor , on work the performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) Read Sworn to and Subscribed before me. STATE OF FLORIDA, COUNTY OF DADE. j 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 Date z Notary Public, State of Florida Building Insiector 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. My Commission Expires