1269 NE 99 St (18)Application] 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. Thin- 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 Flori a. 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
MIAMI SHORES VILLAGE I751,l _ RSO
BUILDING INSPECTION DEPARTMENT
Location and legal description of lot to be built on:
Lott LLf i 'L Bl ,
APPLICATION FOR BUILDING PERMIT
Registered Architect and /or Engineer ,� /
Name and address of licensed contractor (f/t !l" E je
Subdivision
treet and Number where work is to be done /(3-a`( NI rE_- 1 tN ST
Amount of Permit S /tO
Plan Cubage . AC P--
Size of Building L
Date J ' P42—C A4–�j C: 19
No Ae ! Street
0:xruo1c
e— ate work to be done and purpose of building (by floors), state exterior colors (submit samples) � C� t AL � — L�)LL {�OUc$)
1NSTY�tL F2Fzr..iCt+ 5 -( 1nt tL"crST1o.1L, C1Pl?►V1'VC-1 Cc C– aKf.SnMc, ( , y ft21o2 Fl,bolt. w , ;t+
�ZG02.9, ri J�1` W
and for no other purpose.
New Building Remodeling ✓ Addition_ Repairs No of Stories
To be constructed of Kind of foundation Roof Covering
j - E'stimated Total cost of improvements S
Zone cubage required
Distance to next nearest building
Maximum live load to be borne by each floor
0[W
7/ •Zos — oP /a
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 obligatons as an employer of Labor under the Florida 1Vorkmen'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 c. If a 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 e• plo fn such subc. • • work to be performed
Remarks (Signed) under this permit, as are licensed by Miami Shores Village.
%i % f ��
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
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.
loir‘Z
Date
Permit No.
Disapproved
(Signed)
Building Inspector
Date
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
to me well known.
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of 525.00 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 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.
Owner's Name and Address ..... ✓
Registered Architect and /or Engineer
Name and address of licensed contractor
Zone cubage required
Distance • to next nearest building.
Maximum live load to be borne by each floor
STATE OF FLORIDA,
COUNT? OF DADE. ss.
Disapproved
(Signed)
MIAMI SHORES VILLAGE
Building Inspector
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed statement ur 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.
0
p urVQCIA
Location and legal description of lot to be built on:
Lot Block Subdivision c� G
Street and Number where work is to be done /2.e.L 14 .72 •. _ _........_. ...
State work to be done and purpose of building (by floors) .(As9@s? r ....
,&t ....
Ncw Building Remodeling Addition Repairs
To be constructed of Kind of foundation
Estimates Total cost of improvements $ /DV0 • u v
Amount of Permit $.
.Plan Cubage
Size of Building Lot
Date..._... 102-
�»�. 1� Street— 21 & 7i
sr::. r ,. „r::,
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 Snp plement,
and has complied ccith 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 rk such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such subcoyr actors, pD work to performed under this
permit, as are licensed by Miami Shores Village.
Remarks..._ (Signed)
n / aa " _.1alk�
......._...__..._........ and
No. of
Roof Covering
c00
for no other purpose.
Stories _
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 l re ”
Permit No . la� c�a Date e-� l./ 1 .�I kgf Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Cnair:nan Member
Member Member
\icmber .. .. _....._......_..._._ ...._....... 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 hecn obtained Fm,;
the Pl. Board.
A re fce of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials anti /or workmanship.