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806 NE 97 St (3)STATE OF FLORIDA, COUNTY OF DADE. ss. A \i 7.3 ;0* IA t, [1.. 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.