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390 NE 97 St (5)APPLICATION FOR BUILDING PERMIT Application is hereby wade 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. Owner's Name and Address . /fie =- • ... 1: R egistered Architect and /or Engineer __ -.. ,.,.......•,..,•• •,.,- .•.,.m_.,-•. Name and address of licensed contractor/ -?`-= ',;.>" • %' ..._ :' �' s�. Location and legal description of lot to be built on: Lot `# Block if Street and Number where work is to be done Subdivision.. ��e .4" L. S .., Swat � G� tC be done '. 0 ` �o� of buildin b ��rs��� � � prP �gf Y ) �� c �.. 7 ' ._... y: � e ��, c� f r< e `> e "r< and for no other purpose. New (- Bui.ding ". Remodeling Addition Repairs No. of Stories 1 � ' . 1/ Ai STATE OF FLORIDA, COUNTY OF DADE. ss. Permit No.___._ Date Disapproved . (Date.. _...________(_ (Signed) ,,----2......,......, � . Buildi$ i ispector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT y Date..._...4 _ No A)`1. (Signed) ` d PLAN C BOARD DATE Read, Sworn to and Subscribed ' me. To be constructed of Kind of foundation Roof Covering n Estimated Total cost of improvements $ v °5�� ' Amount of Permit $.. -� , Zone cubage required .Plan Cubage 4 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.. d O - . 4 "; ,--- c! 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 of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontr ors, on work to be performed under this permit, as are licensed by Miami Shores Village. '�) > Remarks 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 rear %the foregoing application, and that he did sign the same, and that all facts therein by him sta, ed are true. : Notary Public, State of Florida My Commission Expires 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. OFFICE: 4201 LcJEUNE PIO. ORAL GABLES. FLA. 33148 ;USDIVISION ,�'� 1:' '� :e1 /./a _ " j• CCORDINC TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK PUBLIC RECORDS OF l�ol�G COUNYY, FLORIDA. DATE: "eV/(r' . I r, 97 FOR: CATION SKETCH 1 s !6 /y ' 21 1.470 , T-r SCALE 1 ' W I hereby certifyfliAi this sketch of 7 � 9 survey of the above nescrihed property . ' - as true and enrrocr the best of my knowledge and belief us recently surveyed and platted under nw rectior. I r'urther certify titan this survey meets the minimum t cq ;i 'e°we of s adopted by the Florida Society of Professional Land Surveyors and the > 1. it als Land Title Arsoeiationo TH011411121 J, 104-1.1 Itic LAND MS MI* MIAMI, FLORIDA SURVEY NUMBER- - • r� Sys SURVEY OF :f t f `. • , "t7 ' d /"..7 N `..119t e a e • � BL CF TCLE►MOMt^ Registered Engineri i #9 Regstered Land $utpe'yra6 '1911 State of Florida kT PAGE NO.. s `t" i 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 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. ' ate �� _ 0* ( 19 Owner's Name and Address r • 11 tit - V\. �c� t e ` No _1 �` Street 0 Registered Architect and/or Engineer VV —Name and address of licensed contractor ilivdveie Location and �� f legal description of lot to bee )� built on: f ` AM 1 0 2 Lot W. Block 1 2 Subdivision f f' 1,& 13r j) S 1 ''-''''Street and Number where work is to be done 3(') £tate work to be done and purpose of building (by floors), state exterior colgrs (submit samples) PJ< 2 f w ec- a pe v ,(• e vV W S/C c goA edbd e t New Building Remodeling Addition Repairs X No. of Stories To be constructed of (� Kind of foundation Roof Covering - Estimated Total cost of improvements $ 80Q. CO Amount of Permit S 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 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 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 agrees to employ only such s . ntracto, -, on work to be performed under this permit. as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the unsigned authori a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared _ _ (Signed) o e/� / r_ia ,.,&p krown. and who, being by me first duly sworn, upon oath deposes and says that he is the Oin a /o "Cj'�r`" 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 hilt s tated arm Date 94Wrir Read, Sworn Permit No. 2,14 Disapproved Date Building Inspector My Commission Expires PLANNING BOARD DATE and for no other purpose. r'i:i" „r .. . a i,i C' ' _..,. i I Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship.