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DRIVEWAYApplication 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 andior Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block j / Street and Number where work is to be done �j� / State work to be done and purpose of building (by floors), state exterior colors (submit samples) �v //�� ✓ �// _ J< � f' p I2 r a e Hr 4.1 .A61- . MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT ,041.) T /Kt / and for no other purpose. New Building Remodeling Addition Repairs 1.--- -------....— No. of Stories To be constructed of Kind of foundation Ro f Covering Estimated Total cost of improvements S ZD � Amount of Permit S 37 f 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 The undersigned applicant for this building permit does hereby certify that he understands and accepts his Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement. and compliance from all contractors or sub - contractors employed by him in the work to be performed and on the site of the work such public notice or notices as are required by the Act. The undersigned a under this permit, 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 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 foregoing application, and that he did sign the same. and that all facts therein by him stated are true. Permit No. " Date Disapproved Date (Signed) Building Inspector Date J 5— 19 Rd No. /I, 7 7 Street /7 e Iijg - 5 /l f g 6 1 Subdivision eV � � / o 7 ? A/ a-7 Fs-Lc( S' Read. Sworn to and Subscribed before me. atons as an employer of Labor under the Florida Workmen's plied with t Io isions thereof. and will require similar ermit: a will pos or cause to b- p. -d for inspection mplo on such syb ontractors. ork to be performed Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and -or workmanship. 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 build- ing 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. Dat L C/ 4 flank l Owner's Name and Address._ 0,7 No. Registered Architect and /or Engineer WAR Q l Name and address of licensed contractor K.Y_A!_1 Q � Pji I y `'d R , Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) Permit Disapproved (Signed) Date Buildi Inspector Chairman Member Member Council Approved NOTE: A charge of $1.00 will be made for the Planning Board. A re- inspection fee of 81.00 will be charged materials and /or workmanship. MIAMI SHORES VILLAGE / 77 /\/.- / A/ 5/- ,s and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ - e O 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 perfor ed under this permit, as are licensed by Miami Shores Village. - Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j 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 'e true. Read, Sworn to and Subscribed before me. PLANNING BOARD DATE e PT // , 19 6 �-- 67 7 Street...A /. ?d •ST Notary Public, State of Florida My Commission Expires Member Member Member Date Disapproved Date making corrections 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 il sr 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 build- ing 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 specifiyRl or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date y No O Z Street /Kr .Q sr" I nic Owner's Name and Address ! ?L._ .21/Q 0 4 0 Registered Architect and /or Engineer..._._ Name and address of licensed contractor le. /'C $ yi e- Location and legal description of lot to be built on: Lot Block �ubdivis'on � y Street and Number where work is to be done.___ 7 � _Q ST State work to be done and purpose of building (by floors)._ STATE OF FLORIDA, i COUNTY OF DADE. ss Disapproved Date (Signed) /4 Fetrz- k i ST/ ry � � oW , oq and for no other purpose. New Building �/ Remodeling Addition Repairs No. of Stories To be construe eh L Kind of fo dation Roof Cover Estimated Total cost of improvements $ '�"'�... 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, Pennanent 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 rrs on�ork tg be performed under this permit, as are licensed by Miami Shores Village. ��jj • Remarks (Signed) 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 true. Permit No Lt Date_.., Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chainnan Member Member Member Member Member Council Approved Date Disapproved 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.