1236 NE 99 St (4)pelted
APPLICATION FOR BUILDING PERMIT
A;.t•!nation ic.hcrchy snack for the approval of the detailed statement 01 me plans and specifications herewith submitted for the build
Inc cr o :her structure herein described. This application is madc in compliance and conformity with the Building Ordinance of Miami
airs \',;l.ige, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and ill rules and
regulations of the iiiiildiiig 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.
Date.
O..-ncr's Name and Address / C / t OvN E IRO /'Xr. Str 7 r:... ...._.
Registered Architect and /or Engineer . .,......... 1
,,.....
v C a a7.0w7. . `f1 . ....61 , b Nr�> ..7„f e.
Name and address of licensed contractor
Location and ll s al description of lot to be built on: / ty t 2 es a 9 O / O A. o' � �� Ar
Lot (� Block °1 Subdivision .�? »_ ...... ............. ..._.. •
Street and Number where. work is to be done / - � 1 �.6P*+• - +•- - ••• -�� - • -- — =
State work to be done and purpose of building (by floors) J1l- `r-.7W'I- 7 0 A( •1•1E•• —..••• •.,...., �• 27
..xa.)( 9 7P/is H 1`? -t'/ /C £1 ..
S4 7? /Q VLr d. P and for no other purpose.
Ncw Building Remodeling
To be constructed of hind of foundation
Estimated Total cost of improvements $.•. ..D
Zone cubage required
Distance .to next nearest building.
taairnum live load to be borne by each floor
1 hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to.. ..........
- "ne • applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer '
c. :A:or wader the Honda Workmen's Compensation Act, being Section 59(66, Compiled General Laws of Florida, Permanent Supplement,
ant: ni. : complied c•irh the thereof, and will require similar compliance from all contractors or sub - contractors employe by him
or:: 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 r,c :ices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Stiami 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-
and woo being by me first duly sworn, upon oath deposes and says that he is the.
ci tl.e above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fads
} d
therein by him
stated are truue.. / S . �j
Permit No......_..CT`- cst..,/•.D.. Date...,/ /s1 17 7
(Signed)
Disapproved ��. �_. _Date
Building Inspector
'MIAMI SHORES VILLAGE g e‘
BUILb1111G -i sPECTION DEPARTMENT
PLANNING BOARD DATE
7firros.
Addition... Repairs No. of Stories
Roo vering
Amount of Permit SAP Q
.Plan Cuhage
Size of Building Lot
Read, Sworn to and Subscribed before me.
Member
Member
Member ...._ ................__.._._
to me well known,
Notary Public, State of Florida
My Commission Expires
Cnair:nan
Mciribcr
Mcrnbtr � -
Cot mcii Approved Date Disapproved Date
NOTE: A c h.rrge of S1.00 will be made for making corrections or changes to this application after approval has hecn obtained frail '
the 1'Lumir.� l:u.ud. t
A re- iri••l)et boo fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspectirn or faulty .
materials and /or workinanship.