546 NE 97 St (8)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT.
'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 Ordinan :e 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..
Owners Name and Address ° ° .. _ ._. No ..... Street.....' ....... ............._.
Registered Architect and /or Engineer. •
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done -- " ° " °
State work to be done and purpose of building (by floors) . =_ _ :.
°
• i • ✓ ✓nom r"; r, rl �)' r .. r . 7 7 _
peered
Disapproved .<2 _._�
( Signed) ............,
Building pspector
Chainnan
Member
Member .. .
c
C!!t. )t9•• Tl TT••f T!!t ^! tT 52.1121, t "!
Notary Public, State of Florida
My Commission Expires
and for no of er purpose.
New Building Remodeling - Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ ) 1 ° Amount of Permit S..
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Let
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 const ;uctior_ may
1,
be sent to.. ' '
•
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an c mployer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Pennant -nt 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 rublic notice
or notices as arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
pennit, as are licensed by Miami Shores Village.
Remarks _...._.. —_ (Signed) . . -
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-
.___ to me yell 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 trur - 7 //
�'1�
Permit No..— _i. ✓ ''
Da Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
Member
Member
- ----- _..._. - .• -- -_ Member
Council Approved Date Disapproved Date
NOTE: A charge of 51.00 will be made for staking 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.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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 iuilding Division of Miami Shores Village shall he complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at budding during progress of the work.
Owner's Name and Address ...... - 11 6 .k No.... Street-hi...L ,�•
Registered Architect andior )ypgincer
Name and address of licensed contractor 1 ri-7 6-
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 4' (4f2
State work /I to be done and purpose of building (by floors)._LM32.4h.L._ !SL.' ". -be‘e..
'�11f.�.... adt. 4.4. [' t._l/Ar. iC4:616•... 6 14 01 1.6
Date __d..__ 1 ._ , 119
and for no other purpose.
Addition Repairs No. of Stories
Roof Covering
Remodeling
Kind of foundation
a �
Estirn:,tcd Total cost of improvements $... 9 Amount of Permit $.
Zone cubage required _Plan Cuhage
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 pernitidocs hereby certify that he understands and accepts his obligations as an employer
of labor under the Honda 'Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, I'ernanr•nt Sup clement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hinr
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 arc required by the Act. The undersigned agrees to employ only such su. • .tr � cto rs, on work to be per ormed .under this
permit, as are licensed by Miami Shores Village.
Rem.uks
New Building
To be constructed of
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
and who, being by me first duly sworn, upon oath deposes and says that he is the
of tl.e 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. ___.___ Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman _ „ Member
Member Member
Member .. Member
Council Approved Date Disapproved Date
NOTE: A c•h.Lrge of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained from
tic
Planning Board.
A re :mpcction Ice of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workinanship.
6
(Signed) .
Notary Public, State of Florida
7
1Q
to me well known,