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900 NE 97 St (8)MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application, is hereby innde for the approval of the detailed statement or the plans and specifications herewith submitted for the build inc 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 ?nd all rules and regulations of the Building Divisinp of Miami Shores Village shall be complied with, whether herein specified or not. A dopy a approved plans and specifications must be kept at building during progress of the work. Date.._... _ _ ,19.i Owners Name and Address .... f.7(.C.7 /.1.JGnl1l ....,. .., � /�G� — No.., 0 e) Sfree�t:... 7, -5 r _. Registered Architect and /or Engineer.af/ / /..G te/&!Y .e. fly?.. . ;:s0 Name and address of licensed contractor . .4' 4 ?ey.,5:7 0- .7.&c,,__ 166,?0 Location and legal description of lot to be built on: /� Lot..,�. .P . ... 2. � Block 7g Subdivision / J' '?' - x�f/1/ S .,C -7 . Rein.uks ,. (Signed) Street and Number where work is to be done 9 &Q .i ac=. %., 9 7 ,' _ 'T -- State work to be done and purpose of building (by floors) "2,4 ©-' 619.e2cW ° c-- — and for no other purpose. New Building Remodeling Addition v Repairs.., No. of Stories — fie-.be t��izte., Kind of foundation Roof Covering Estimated Total cost of improvements 5..��?. C' o Amount of Permit $.. r cu a 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 ,S/ydva e...e....eoti -s.T &a ,� , -c 07" //Z r q'e be sent to.. � ' 3 /G The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of Libor under the Honda Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied ssitli 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 arc 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. —C7749,<" 4 g�iC • STATE OF FLORIDA, COUNTY QF 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 careful) read the foregoing application, and that he did sign the same, and that all facts therein by him stated are tru Permit No %l Date MI 9 Read, Sworn to and Subscribed before me. Disapproved .. Date.._.. ...... _. ...... .._.._ ,• (Signed) k Chairman Member Member .. _ ..... --- Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Member , T r Member Member Council Approved , Date Disapprcrvod Date NOTE: A c•h.irgc of $1.00 will be made for making corrections or changes to this application niter approval has been obtained irons the Pl,rnnir,;; Board. A re- ni'pection Ice of $1.00 will be charged when such re- inspection is made necessary by Improper notice fpr inspection pc faulty materials ant /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT AiNtslicatio is hereby made for the approval of the detailed statement ur me plans and specifications herewith submitted for the build • ing or others cture herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the iuilding Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progreu of the work. _... »._�.. » ... Owner's Name and Address . ' l� Zi$Vrl 0 � � .�.��.1?�'.f:.d',S _ D .._.. Street..CF" .. Registered Architect and /or Engineer.... L,�a047vi"4/ G- /lj..5;9A•P,., • 2 U ST G - Ziy : ;42C /!S Name and address of licensed contractot.. _ ..� _...� /'` _._....�.._...�_...7.� ..J?'•. » Location and Legal description of lot to be built on: Lot / Block Z 2/.1, ....... ..•,,,,nn,.e..•,•nt.,..,en,,,,. Subdivision ./1!.‘e Z i ... _: 7 " 2 ' ®: 5 ' — Street and Number where work is to be done .... ©a L�- �..._. "l �....�.. __.... ».._ State work to be done and purpose of building (by floors)....--C‘?- . Chairman Member Member .. .. ».. - ....._..._._ ..... Council Approved PLANNING BOARD DATE and for no other purpose. New Building Remodeling Addition Repair; No. of Stories To be constructed ofe • ',...6�!1.> i:in foundation joo�f Estimated Total cost of improvements S.•/ 9 •047 • 00 Amount of Permit $..... Rte✓ 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 be sent to._S'/yflriif)ef ...efeo. >tT .C'c'. 7.70 .77%6: f ® " SiT /7/6 ./7 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of i.ihur mile,g,J.ile Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida, Permanent Supplement, and has complied itlt• the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in tkc 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this — perrnit, as are licensed by Miami Shores Village. 5 d) � �i� T Ca • �i+'C Remarks ( Signe and its construction may STATE OF FLORIDA, COUNTY OF DADE. i 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 h by hi d therein y m stated are e. Permit No.. .. (� Date... "l Read, Sworn to and Subscribed before me. Disapproved � Date Notary Public, State of Florida (Signed) Building Inspector My Commission Expires _ ...._... _..._....»._ ..� ._. Member Member — Member ...._ — .._._ _.._.._.. Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after appmral has been obtained from the I'I.rnnir.. Board. A re- inspection fce of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty materials and /or workmanship.