823 NE 96 St (5)Disapproved
(Signed)
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
.Application is hereby made for the approval of the detailed statement or me 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 building during pregreu of the work.
Owner's Name and Address , P4. 11 ./
........N...I .L....... P.°'`.2 � 4 _ ._ No. » ............._ . Street._... _
Registered Architect and /or Engineer _.. •1 .••1*1• -1•Mt !, .....
Name and address of licensed Zit ' 4/6- iQ2.0 /r z : r�, - 4 /14: 1 0
Location and legal description of lot to be built on:
Lot Block Subdivision yy ..._ —.
Nu 't-'t-..3 & 41'6 � /---
Street and number where work is to be done � ' e 1. / ••- •._._— .— .... -- —
State work to be done and purpose of building (by floors)....L 4-).-r":1111-' ✓frie14J 3 r-- - - ...P_te7-
New Building Remodeling Addition Repairs No. of Stories _
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ a- t9 0 Amount of Permit S....9j
Zone cubage required Plan Cubage
Distance .to next nearest building. Size of Building Lot
\faxirnum 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 5e966, Compiled General Laws of Florida, Permanent Supplement,
and has complied ssith 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 ulrlic notice
or notices as are required by the Act. The undersigned agrees to employ only s on or + be perfo i ' under this
pcnnit, as are licensed by Miami Shores Village.
Remarks..._ (Signed)
STATE OF FLORIDA,
COUNTY OF 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 carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true..
1 J Permit No.._...._........— D ate li " Read, Sworn to and Subscribed before me.
Date
Chairman
Member
Member ..
Council Approved Date
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re-inspection fee of $1.00 will be charged
materials and /or workmanship.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
-
5/..6722
and for no other purpose.
Member
Member
Member ...._ .............. - -.._. — .. - ...
Disapproved Date
or changes to this application after approval has been obtained from
when such re- inspection is made necessary by Improper notice for inspection or faulty
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THESE PLANS ARE APPROVED FOR
ISSUANCE OF A BUILDING PERMIT
VARIANCE(S) LISTED IN "REMARKS"
MIAMI SHORES BUILDING AND ZONING
UNLESS SPECIFICALLY LISTED BELOW.
AND COUNTY LAWS MUST BE COMPLIED
Aut "ol'ed Stnoture Date
• WITH NO VARIANCES • WITH
NO OTHER DEVIATIONS FROM THE
ORDINANCES WILL BE PERMITTED.
ALL OTHER APPLICABLE STATE
WITH BY ALL PARTIES.
FIRE DEPARTMENT
PUBLIC WORKS
POLICE . DEPARTMENT
BUILDING DIRECTOR
0&-j\?IsSI-AV
Iq
PLANNING & ZONING 130;.:
VILLAGE COUNCIL
APPROVAL
PRELIMINARY: ANAL:
REMARKS:
COMPLIANCE WITH THE SOUTH FLORIDA BUILDI.G CODE AS ADOPTED
BY MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER
SUB CONTRACTORS r;;E ".: "'•. .-:'; ' '' 'r 'O.`;1E!CE OF
ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED
&
A!! BUILD-
HEREIN.