882 NE 97 StState work to be done an purpose of building (by floors)
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 building
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 regula-
tions of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans
p kept building during progress of the work.
and specifications must be e t at
8 g c
Date_– l - - - --' d , 19i • ,. Ff , — a _— –
Owner's Name and Address "'" % �
Registered Architect and /or Engineer
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 ' 3 Cr y =_c,
New Building_______ __ ___ Remodeling____—________ Addition
To be constructed of of foundation F_� __� 0 __
P '
�- _- .�Ltnd �ation � �',? i2oQf Covering_ 4' .I !i �_���
Estimated Total cost of improvements $ � L�) �t g _Amount of Permit $ °
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 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 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. r 1 �, 1
Remarks (Signed)
No Street
Repairs No. of Stories__________
Disapproved 4 ,v • Date
N ; .,
(Signed) - =� 4 _ y , = === =±—
Building Inspector My Commission Expires_____
PLANNING BOARD DATE
Chairman Member _
Member Member
Member Member
Council Approved_ Date Disapproved
STATE OF FLORIDA,
COUNTY OF DADE. f se.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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 be did sign the same, and that all facts
therein by him stated are true.
Permit No Date Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
and for no other purpose.
to me well known,
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.
Permit No
Disapproved
(Signed)
Member
Council Approved__
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 building
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 regula-
tions 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 �� 741
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot_____— ______ –___ Block___ __ Subdivision
/P, ry ` � M
Street and Number where work is to be done_____ __ _ 'C .___ /
State work to be done and purpose of building (by floors)
Member —
Date Disapproved
r,
,.
Date_— __'� _ , 19_
------ - - - - -- - -- -- _ ___ _and for no other purpose.
g___ g Addition Repairs No. of Stories__________
New Building____ Remodelin
r
To be constructed .
of_ ���? r _ � ?__ �� g L_'
_s. •— Kind of foundation _� Ro f Coverin _
e;°,
Estimated Total cost of improvements $_ 1_ &S °3 __� ____ ,Amount of Permit $ .1 —_
Zone cubage required —_Plan Cubage
Distance to next nearest building___ _ �_ _w___ _ —_ _ _ _ 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 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 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 subcontractors. on work to be performed under this
permit, as are licensed by Miami Shores Village. ^
Remarks (Signed) (, '� ` . c
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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 ".--)
tated are rue
Read, Sworn to and Subscribed before me.
Building Inspector / My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Notary Public, State of Florida
to me well known,
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.