1228 NE 98 St (4)Owner's Name and Address MR' & MRS. TIRELLA 758 -1343
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
orn to and Subscribed before me.
Application is hereby made for the approval of the detailed statement of me 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.
Date
Street-28..ST...IIIAMI..SHORES.
Registered Architect and /or Engineer ..... . ........................•.,.
Name and address of licensed contrActor S :_..._.. N.W. 72 AVE. MIAMI FLORIDA 33166
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) REPLACING 23 JAL WDWS WITH 23 ATW AND 1 P/W IN EXISTING OPENINGS.
_ ..b10 STRUCTURAL CHANGES..
and for no other purpose
Ncw Building Remodeling Addition Repairs No. of Stories _
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ ....z4S..QRQ Amount of Permit S.
Zone cubage required plan Cubage
Distance .to next nearest building Size of Building Lot
\laxiunum 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 .ligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5 Compiled General Laws of Flo da, Permanent Sup plenrent,
and has complied with the provisions thereof, and will require similar compliance from all contractors or su. 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 si of the work such ululic notice
or notices as are required by the Act. The undersigned agrees to employ only such s .ntractors, • rk • der this
pcnnit, as are licensed by Miami Shores Village. i i i
Remarks
Z0 9-s(cY
STATE OF FLORIDA,
COUNTY OF DADE. i ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared $ vi
to me well known.
and who, being by me first duly sworn, upon oath deposes and says that he is the. ..t ^/6
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.
Date � .1�° /1 Read,
Permit No.._..
Disapproved Notary Public, State of Florida
(Signed) v My Commission Expires *T��g FDA
BONDED iHRU GENERAL INS. UIND.
PLANNING BOARD DATE
Chairman Member
Member Member
Member .. .. _.- -- .- -- ...._..._._...._....._ Member
Council" Approved Date Disapproved Date
NOTE: A charge of S1.00 will be made for making corrections or changes to this application after approval Isns been obtained from
the Planning Board.
A re- inspection fee of 31.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty
materials anti /or workmanship.
/Date
Building Inspector