740 NE 96 St (6)MIAMI SHORES VILLAGE
a BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIIT
Application is hereby mode for the approval of the detailed statement ur 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 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 budding during progress of the work.
--=', ®® 1 Date..._...._...._._.... 4:a4w .,..�_..._.__._.......... ,19.L:.
Owner's Name and Address . ➢..fi�..6.r .ir:.U. I��..a.. •_ No..7.`.f.... Str ) - j 4.L
Registered Architect and /or Engineer .,.., ...•••n.• renmarwt•tmnm. enett.
Name and address of licensed contractor.. , 4.44._1_l .t.2 ...r:...q..1.. ...S...U.Gi...31. '
Location and legal description of lot to be / built on: U {7 1� Nei -.
Lot.lii..,4, 41 A .8..... Block (pr Subdivision... .o'..cr .. .... d .l Q.lt4- Z.....
Street and Number where work is to be done .....1 ..' 0_1.1 e:_ .5 I_._ ..n...t.. 31� i. ..L.L9..E.S=. 5— ._
State work to be done and purpose of building (by floors)........
c/J '.c.. rRc' C ZL%a. . *
....._........and for no other purpose.
SS.
therein by him state are true.
Permit No... • Date d. . .Y..
Disapproved .... t ..1� ..:. Date —
(Signed)
Building Inspector
C'rtair:nan
Merr,bcr
Member.. .. _.....__....._. ...._.. -• --
Council Approved Date
NOTE: A charge of 51.00 will be mode for
the Planning hoard.
A rein %pection fee of 31.00 will be charged
materials anci /or workmanship.
PLANNING BOARD DATE
New varturng • Remodeling Addition Repairs..... No. of Stories _
e e nQ
To be constructed of ...0 /� Kind of foundation dation C . k:: : .t,...lt,.; ■ tC. .Roof Covering I g 1 A..t/.i1.4..... I
Estimate Total cost of iniproveinents S 715
Zone cubage required
Amount of Permit $
.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 - kidding permit does hereby certify that he understands and accepts his obligations as an employer
of Lthur under the Flondk\Yorkuren's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup dement,
and has complied with the provisions thereof, and will require similar compliance From all contractors or sub - contractors employe by him
in the work to be performed nndcr 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
pennit, as are licensed by Miami Shores Village.
Rem.uks..._ __._.__ (Signed)
��•� - rte � '
STATE OF FLORIDA,
COUNTY OF, DADE.
Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
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 dicl sign the same, and that all facts
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
MyCommiuion Expires .. ._..._........ ._...._..._.._._, _._.
Member
Member . —
Member
Disapproved
to me well known,
Dat
making corrections or changes to this application after apprmal bas been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
4'
Ickarod G
7�foN�
hl SkoltPs
d:151/-6314
123.03-94
BUILDING & ZONING - ADMINISTRATION
PLOT PLAN
7.5
NO SCALE
Legal: Lot No.W i * * Block No
TERR., AVE., CT., PL.
Gs)
Subdivision M;a) -, S 4, n rt.P s SEC. 3 TWP. RGE
or
Metes & Bounds
Plat book and Page No /0 -31
NOTE: 1. Show existing buildings and additions.
2. Show distance from property lines to buildings and /or new additions.
3. Locate septic tank or sewer and electrical service.
NORTH ARROW