858 NE 97 St (4)APPLICATION FOR BUILDING P
Application is hereby made for die approval pf the detailed statement ui me 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 ....... L211/..Q....... 4. m
Disapproved
(Signed)
Building Inspector
Registered Architect and /or Engineer..
Name and address of licensed contractor O (1E4 7
Location and legal description of lot to be built on:
Lot, . 1 , 1 . or f07 . ?. .,... Block
'• , /ac,
Street and Number where work is to be done
State work to be done and purpose of budding (by floors)
A0004 R0c2) fhpy 7,0'9 /ve
HHosea,
47/ No
n>sr
Date
Chairman
N1crr,ber
Member ..
Council Approved Date
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date..._.........._ id d / /C_» ,19.._._
_ No Ce S streetJ`/.1 p✓17 3'r
/l ids N. E. ( 7 4 1 S 7. ,5,90;4(5 ) ,
yea
Subdivision SMo4 t 5 jar 7.0 `U
es 1 :..:.... r9 17 - .... r-
S /4/6 a5 ?oA�i b UE ri 114 R CS /QcXIC
(4/7/1 / /q L /' /7c11‘49
PLANNING BOARD DATE
New Building Remodeling X Addition X Repairs
To be constructed of C' iS• S'• Kind of foundation COsur Roof Covering 13 • (..W. 6 .
Estimated Total cost of improvements $.., / 0 Amount of Permit $.
Zone cubage required , plan Cubage
Distance to next nearest building , Size of Building Lot / ..l /a .._.....
Maximum live load to be borne by each floor
.I hereby suit all the Opts and specifications for said building. All notices with reference to the building and its construction may
be sent to.. N...P.O.. e /a /k8 V•kr- C9 4u11 -d 3�7•7Q
Tir undersigned applicant or I u s building per:nit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Flonda Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup ,lenient,
and has complied ss ith the provisions thereof, and will require similar compliance from all t , tractors or sub - contractors employe by him
in the work to be performed under this permit; and will post or cause to be posted for ins op the a of the work such public notice
or notices as are required by the Act, The undersigned agrees to employ only such su • y 1" ctor `" rk to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks _ ». —._.. (Signed)
and for no other purpose.
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorizcd 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, rod that all facts
therein by him stated are e.
Permit No OYg/ – f Date 14 ' "s' Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires ,
Member
Member
Member
Disapproved
corrections or changes to this application after approval
NOTE: A c•h.irge of $1.00 will be made for making
the Planning Bo.rrcl.
A re- ,:,'pr•ution fee of 51.00 will be charged when such re- inspection is made necessary by improper notice
materials and /or workmanship.
No. of Stories , /
CC 3o
Date
has been obtained from
for inspection or faulty
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby mode 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.
i Date.. _ _i. _..__ ._._..._...
RW' 4) C - _ ..L.[ th . .5,x'2 ..... str ,,,,11 C cc ST
Owner's Name and Address �— .... No.... eet1.K. ... 1.7 '
Registered Architect and /or Engineer ,..... .<,..,:„,,, „,,,-,,..,,!- „,,..,,.,,,.
Name and address of licensed contractor 4- ‘uT>,--1-J --- _....
Location and legal description of lot to be bui t on:
Lotfi fia.i 14g Yaf . Block 1 Subdivision _ _......
Street and Number where work is to be done ,
State work be done and p ose of building (by floors) ..1�3� GR - ^ Y
ot.dr .(4) 4,eD-r 2 .. -t,
and for no other purpose.
New Building 1” Remodeling (/ Addition Repairs No. of tones
To be constructed of............ Kind of foundation hh �
Roof Covenng.
Estimated Total cost of improvements $ S? e Amount of Permit S�
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 pennit 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 Supplement,
and has complied with the provisions thereof, and will require similar compliance from all tractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for insp 'lion on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcon actors, on work to. be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j ss
oaths and
Before me, the undersigned authority, a notary public, duly authorized to adfiiinister
peared
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.
Disapproved Date__
( Signed)
Building Inspector My Commission Expires
Notary Public, State of Florida
take acknowledgments, personally op-
to me well known,
PLANNING BOARD DATE
Chairman Member
Mcrnbcr Member
Member ...... Member ...._ _.. _ w.._..._
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 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
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