806 NE 97 St (3)STATE OF FLORIDA,
COUNTY OF DADE. ss.
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I SHORES VILLAGE
BUILDIN INSPECTION DE ARTMEN
TION 1I UL RN PE MIT
Application is hereby made for the approval of the det,iled statemen• of the plans and specifiLa.ions herewith submitted kb: the build-
ing or o h. -ructure her i described This r licatic is made in compliance and con ty w.th the Building Ordinance of Mia
Shores Villave, or da, and all pro isions of the Laws (. f the Statu cf I krid. all o d nances if Mi - in Shores Village and all rules and
regu a ion. of the Building Div i of -lam Sho, iilage '1 ,e ipl.ed with, whether herein specified or not. A copy ot approved
plans and specaficati must be kei • at bur..cling durin progress of tl.e wcrk.
Date 11 A/54 19
Owner' Name and Address Thg;o. Stalsiar No 806 Street_n_ 97th St s
Registered Architect and/or Engineer
Name nd address of licensed contractor _Laug_llooring_ms1. _Co.., __Ino..,430 _N. IL _79th St ..,. V-ktafi,
Location and legal description of lot to be built on:
Lot Block. Subdivision
E„._ 97th $t,
&reel: and Number where work is to be done. 806
State work to be done and purpose of building (by floors) 1-301 fait,. 2-15.# lelta 8c._grEsKal
New Building. Remodeling Addition, X. Repairs. -
To be constructed of _ Kind of foundation Roof Cov ring. ilt Up_
Estimated -,tal cost of improvements $. 95..03 Amount Permit $__ 5..00
Zone "ubage required __. __Plan Cubage_
Distance to next nearest building __Size of Building Lot
Maximum live load to be borne by each floor -----
hereby submit all the plans and speciaivations for said building. All notices with reference to the building and its construction may
be sent to _ _
The unde signed appli ant for th"s bulding permit does hereby certify {'iat he understands and accepts his ..bligations as an employer
of 1 bor under he Florida Workmen's Compensation Act be'ng S. -Eon 5966 Coi p led Gen al Laws of Florida P r anon nent,
and h s compl ed w:th he prov'aons thereof, and will require sTnilar comp lance from all contractors or sub-contractors cmplo •ed by him
in the wo k to be p ri med under th s pern it and ill post or cause to be posted for inspection on the site of the work su :h noti e
or •otiLes as are requir d ly the Act. The u. cl. r ign d agrees to employ only such abcontr. ctors on work to..be perform d der this
permit as are licensed by M am, Shores N. ge. L4lig o f 'ing and Tile co Inc.
op
Remarks_ (Signed)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths “nd take acknowledgments, personally op-
pc,nrcd _ _
and who, being by me first d. ly cworn, upon oath depooes and says that he is the
of th abov de L ibed istruction h has careially read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are tr ie.
Permit No 211'(r'
Date_ Read, Sworn to and Subscribed before me.
<-
Disapproved Date.
Notary Public State of Florida
(Signed)
Bt ng Inspector My Com:nission Expires
-7 t
- and for no other purpose.
No. of Stories
to me well known,
PLANNING BOARD DATE
Chairrnan _ Member
Member Member
Member _ Member
Council Approved . Date Disapproved Date
NOTE: A charge of $1:00 will be made for making corrections or 2hanges to this application Ift,-r approval his been obtained from
the Pianr ruy, Board
A re inspectioyr'ee of $1.00 will be charged when such re-inspection is m, .e necessary by improper notice for inspeytmi or fa. Ity
platerials and/ orkinanship.
Disapproved Date
(Signed)
MIAMI SHORES VILLAGE
BUILDING 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)iErein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
, g /'
Owner's Name and Address,_
Registered Architect and /or Engineer o,
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 r
New Building Remodeling
i
To be constructed of ! Kind of foundation
Estimated Total cost of improvements
Zone cubage required
No. _J . Street_
State work to be -done and purpose of buildingjby floors)_______
and for no other purpose.
Distance to next nearest building
Addition
Date
Repairs No. of Stories
r i
Roof Covering
Amount of Permit $
Plan Cubage
__Size of Building Lot
Notary Public, State of Florida
Maximum live load to be borne by each floor
I hereby subiyit all the plans and specifications for said building. All notices with reference to the building and its
be sent to 1 =� -� % %i
19-
construction may
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio;:s 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 the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcyn a tors, on wprh to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
fib
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. Date Read, Sworn to and Subscribed before me.
Building Inspector 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.