3656BUILDING 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 specifications must be kept at building during progress of the work.
Owner's Name and Address._._DeBYI._L_..C.sells ECA
Registered Architect and/or Engineer
Name and address of licensed contractor Brady Roofing & Sheet ?fetal - 295 N. W. _ j3rd St.
Location and legal description of lot to on:
Lot__ BI Subdivision _---------------- .---- • - -_ --
Street and Number where work is to be done 602 N. E • 96th St.
State work to be done and purpose of building (by floors). _ _Roofing_ ppa
and for no other purpose.
New Building_.__ _ Remodeling Addition Repairs X. _ No. of Stories
To be constructed of Kind of foundation____.____ — Roof Covering
Estimated Total cost of improvements $ 4 .00 :00 ._..___ __Amount of Permit $.._5.
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 . s an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Perm•.. /. t Supplement,
and has complied with the rovisions thereof, and will require similar compliance from all contra ors or sub- contractors J �ployed 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 ch ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such . bcon. 1 o _, work to be ,; j /rmed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Sign
STATE OF FLORIDA,
COUNTY OF DADE. SS '
uilding Inspector
MIAMI SHORES VILLAGE
Date.
No._.S�d:Q__ a1 dSt g ourSe
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
PLANNING BOARD_ __.________- ____________ —__. ___-_DATE
Chairman -__-._ _ _ — _ Member - - - - --
Member ________ Member
Member Member
Council Approved- _-____,___._ ___.__ _ ___ Disapproved •
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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
Permit No. Date../.. � � ` �"!_ — Read, Sworn to and Subscribed before me.
Disapproved
(Signed) :-
Notary Public, State of Florida
My Commission Expires__
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 81.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
1
Date