485 NE 96 St (7)BUILDING INSPECTION DEPARTMENT
APPLUCATION 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.
Owns 's Naito and Addeess ..
Registered Architect and /or Engineer a _ _
Name and address of licensed contractor. __ewe ArejeS e 1101 4fAi t c _ meow ..?3/4(
Location and legal description of lot to be built on: - .
Lot 491 Block a Subdivision MithA FA ataeS' PICI S ge-12. 1 -
Street and Number where work is to be done 195We F a_51-
State work to be done and purpose of building (by floors)._ Vk lE
Disapproved
(Signed) ti1/4-i..F
MiAMi SH®
Fes'
Date
mg Inspe or -
ES VILLAGE
e / ° Date. .__...._.__ 9.
and for no other purpose.
6.c
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, P
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub
in the work to be performed under this permit; and will post or cause to be posted for inspectio the s' f the wo
or notices as are required by the Act. The undersigned agrees to employ only such subcontrac f } on rk to be
permit, as are licensed by Miami Shores Village.
Remarks
(Signed)
Read, Sworn to and Subscribed before me.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
do —
Estimated Total cost of improvements $ Amount of Permit $,.. Qsz
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot v
Maximum live load to be borne by each floor
I hereby submit all t h plans spec ations for said building. All notices with reference to the building and its construction may
be sent toy r_C , 5 ' e & e 7/ 0 -M/ it 3
The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
)Iemen
by hi
lic not
under
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 y are true.
Permit No [3.76Y Date 11
Notary Public, State of Florida
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.
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7
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7101 N. W. 69th AVENUE • MIAMI, FLORIDA 33166
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COMPLETE ERECTION SERVICE-ALL TYPES AND I4EIG4TS OF CHAIN LINII FENCE
OESIDENTIAL 0 INDUSTRIAL * CEMETERIES 0 SCHOOLS 0 INSTITUTIONS 0 PARRS PLAYGOOUNDS ° GOLF LINGO