801 NE 97 St (9)Owners Name and Address . �. �ie
STATE OF FLORIDA,
COUNTY OF DADE. SS.
Date
Disapproved Date.
( Signed)
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR '= UILDINO 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 h& -rein 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.
Date.. � l �' ._......_._._...._.... , IlB..�_
fit. �Z.� T.
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Registered Architect and /or Engineer. •.• • v ''// ' 4'
Name and address of licensed contractor .V _ ,..-1, Location and legal description of lot to be built on:
Lot /3 Block ,--,. . Subdivision
Street and Number where work is to be done
State work to be done and purpose off (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 Total cost of improvements $ 2 -- .S�' v Amount of Permit w
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 cfdes 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 t e site of the work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such s n detor , n work to be perf¢r ned under this
pennit, as are licensed by Miami Shores Village. �
Remarks._._ (Signed)
...._....__. Street_
.T1••T:.f••CT••1 ^•!T1... .1TT1111 2.1
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 are true.
Permit No.. /S-7 `f
Read, Sworn to and Subscribed before me.
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 foz miahing corrections or changes to this application after approval has been obtained from
the Planning 11o.ud.
A re inspection fee of $1.00 will be charged when such re- inspection is mado asececsnsy by improper notice for inspectiane as faulty
materials and /or workmanship.
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Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address
Registered Architect and /or Engineer_ JD '
Name and address of licensed contracto
Location and legal description of lot to be built on:
Lot t3 Block 7 3 Subdivision
Street and Number where work is to be done 0 I_
State work to be done and purpose of building (by floors)____
Zone cubage required .Plan Cubage
Distance to next nearest building _____________Size of Building Lot
Maximum live load to be borne by each floor
I hereb . mit all th l a s nd specifications for
,e._ }
be sent to � -_. __ s__
Disapproved
(Signed)
MIAMI SHO
APPLICATION FOR BLIILDINM PERMIT
BUILDING INSPECI1ON$ DEPARTMENT
Date /—
Chairman
Member
Member
Council Approved Date
VILLAGE
P Date__ - Build' pector
PLANNING BOARD DATE
Date . ` ' ' 196
®1 Street
SL
and for no other purpose.
New Building Remodeling
To be constructed of ' d of foundation►_ Roof Covering
` / � �
Estimated Total cost of improvements '� 00 Amount of Permit $ -s'
Addition Repairs No. of Stories
Read, Sworn to and Subscribed before me.
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice
materials and /or workmanship.
said building. All tice with ref- - nceto the b ilding and its construction may
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 Sup lenient,
and has complied with the provisions thereof, and will require similar compliance from all contr -ctors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted f.. inspection'; the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ t. -, such on act • w k to be performed under this
permit, as are licensed by Miami Shores Village. a
Remarks (Sign :: % �.
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 are true.
Permit No 49 3 .2 —
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
Disapproved Date
has been obtained from
for inspection or faulty
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