1122 NE 98 St (12)/
Miami' Shores Villeg*
Miami
Florida
Oa the 15th day of October, 19 4, eresaal r eared before
aw Dist MeG aley, into being day Std, d that he
beet Bad 99, for Lot 20, Block ISO* Ili 5 Mimes.
October , 5, 1917
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.
Owner's Name ; and Address__
Registered Architect and /or Engineer _1!__
Name and address of licensed contractor ___ 'R
New Building__
To be constructed of C 1 4 Kind of foundation
Estimated Total cost of improvements $ De' 6
__ t
Zone cubage required L_4,
Distance to next nearest building
pear ed
Chairman
Member
Member
p MIAMI SHORES VILLAGE ��'p
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
0 -Q
� _LO J _ 4) /W , 19
,_S_ Street_ 4
Date
/4
Location and legal description of lot to be built on:
Lot _ Block i___ �,_ Subdivision
Street and Number where work is to be done___,.., __9_— , , !w '' d-i4-.
State work to be done and purpose of building (b flbors)
and for no other
Re odeling Addition Repairs • No. of Stori
Co er
and who, being by me first duly sworn, upon oath deposes and says that he
of the above described construction, that he has carefully read the foregoing
therein by him stated are true.
Permit No Date
Disapproved Date
(Signed)
Roof Covering
Amount of Permit $
_Plan Cubage
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 _:.r dement,
and has complied with the provisions thereof, and will require similar compliance from all contwctors or sub- contractors : ° ° •,. by .;
in the work to be performed under this permit; and will post or cause to be posted for inspe on on the site of the work such
or notices as are required by the Act. The undersigned agrees to employ only such sub bonrrs, on work jp be perfor
permit, as are licensed by Miami Shores Village.
Remarks (Signed).
STATE OF FLORIDA, f
COUNTY OF DADE. ss.
Before me, the undersigne uth or' o a not public, duly au rized to administer oaths and take acknowledgments, personally ap-
to me well known,
is the__
application, and that he did sign the same, and that all facts
orn to �andd Subscribed me.
Building Inspector My Com
PLANNING BOARD DATE
Notary Public, $ Florida
mission Expires__ /9 y
ose.
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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Zone Req.Cu,Ft
• 1 4 G
Plat Restriction Checked by
To Planning Board
Re- Submitted to P.B.
Plans & Spec. Checked by
To Council ,,//nn
Bldg. Permit No. "I' �c
Type
I umb .Ing ` nspe c t ion.
Roughing
Fixtures
Sewer
Septic Tank
Solar Heater
Final Certificate
Fcctrical Inspection
Roughing
Fixtures
Final
Tema 00K,
Service p to P
New Construction
lumbng •emit No..
Septic Tank
Sewer
Mis c ' l
New Const
2lectrica Permit
Fixtures
Heater
Motors
Misc_tl
New Construction
Building inspection
Foundation
Beams & Lintels
Final
Final Clean -Up
040
/'/"/
Cu. Cont . 's;$ By_ Ce
,
Approved ✓ Re jeete.
Approved - Rej.et
Approved Re5
Date P'ee / VI Cosh
fo% Roof
Repair
Stories
Alterations
e (
Date
If
u
R,
Al eratton
ate
B
u
n
e
t .rat on 'repair -_
e
If
R
r
u
H
u
e
e-insp By Re-Inap By
•