765 NE 96 St (8)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 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
Registered Architect and/or Engineer
Name and address of licensed contractor
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Location and legal description of lot to be built on:
Lot / Block £^ 7 Subdivision
Street and Number where work is to be done G
State work to be done nd purpose of building (by floors). state exterior
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New Building Remodeling Addition
To be constructed of
Estimated Total cost of improvements S 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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to
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The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 mploy only such subcontractors. on work to be performed
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under this permit, as are licensed by Miami Shores Village.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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colors (submit samples)
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Remarks (Signed)
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Kind of foundation Roof Covering
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Street
and for no other purpose.
Repairs No. of Stories
STATE OF FLORIDA
COUNTY OF DADE. ss.
Before me. the undersigned authority, a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared
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 foregoin application, and that he did sign the same. and that all facts. therein by him stated are true.
Permit No. 7,4169 Data 14 4 Read, Sworn to and Subscribed before me.
Disapproved � t,\ (J Date
(Signed)
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Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of 825.00 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 525.00 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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SKETCH OF SURVEY
SURVEY of Lots 10 and 11, Block 69, of "MIAMI SHORES, SECTION THREE"
according to the Plat thereof recorded in Plat Book 10 at Page 37 of
the Public Records of Dade County, Florida, being situated in the
Village of Miami Shores.
ORDER NO. 7421 DATE: February 28, 1983
F.B. 286, P. 76 SCALE- As shown
WE HEREBY CERTIFY: that the attached SKETCH OF SURVEY is true and
correct to the best of our knowledge and belief as surveyed and
platted under our direction in February, 1983. We further certify
that this survey complies with the Minimum Technical Standards for
Land Surveying in the State of Florida, Chapter 472, of Florida
Statutes.
A. R. TOUSSAINT & ASSOCIATES INC.
LAND SURVEYORS
620 N.E. 126 Street, North Miami, Florida
By:
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Howard C. Gamble
Registered Land Surveyor No. 1683
State of Florida
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