800 NE 97 StA -58
CITY OF MIAMI
FLORIDA
OFFICE OF BUILDING INSPECTOR
APPLICATION FOR BUILDING PERMIT
(A copy of this Application, together with one copy of plans and specifications, must be kept at building during progress of
the work)
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 the City of Miami, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Miami, and all
rules and regulations of the Building Department of the City of Miami, shall be complied with, whether herein specified or not.
...... W.:...
Owner's Name and Address _No._. _......_...._ Street___......_..._...__...._ _ _....
A rchitect....,....._.. _.. ... __..____ _ _ ..._ _ __ _...._.__.
Name and address of contractor or builder
Location and legal description of lot to be built on:
Lot—, _Block__ ___. ._._.___.._. ._._._-....._..Subdivision_..._
Street and Number where work is to be done_: /_ %7 : ' -
State work to be done and purpose of building (by floors)...__
__...._ _ __ ._.__.._....._...__....._._.___ _ __..._ _..._...._•......_.._._ ........._._......_.....__...._ and for no other purpose.
New Building Remodeling___... ..._.. _ _ _Addition_.___ Repairs No. of Stories_..._....._
To be constructed of___....__ _ _. ...._...__...._............Kind of foundation_ Roof Covering
Estimated cost of improvements $ _. .._........_......_...Plumbing _....____ Elec
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 construc-
tion may be sent to
STATE OF FLORIDA,I
COUNTY OF DADE, f
(Signed)
(Signed)
Before me, the undersigned au;hbrity, a notary public, duly authorized to adminiyter oaths and take acknowledgments, per-
�
sonally appeared__....y_ _.. _._!� ^ ter:! /i %nom %��. �. ' � J =yi / % %
_.�_ __•_._._...._.....__. _._....._....__.._....._....._. _.._...._,,......._._._ ..� _.. .._.�. ____....... me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the_..._�.a
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.
,
Read Sworn to.apa Subscribed before me,
O_.,'/. i„ %� � �`'' Notary Public (Signed)_.._._._.
My Commission Ex ire w
y P �"i3i�,
y Comuris "on E ;(pins Feb 23 T 9 s pace represents the Lot; indicate the building in space showing
7 3 7 the stance from lot lines and other buildings.
Permit No _ _ __ _ _._ __..... -.__. ....___ as
issued on above application.
Classification____________.
_.
Disapproved_._..
Reasons______....._._._.._..._.... ____......_..._..______....—
J 2 t %v /'
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