125 NE 98 StMIAMI 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 specified or not. A copy of approved
plans and specifications must be kept a` building during progress of the work.
19 if
Street and Number where work is to be done
Building Inspector
I'.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot / Block Subdivision
State work to be done and purpose of building (by floors)
New Building Remodeling
To be constructed of 5 Kind of foundation
Estimated Total cost of improvements $
p 7"/Y (.
Date
No Street
Amount of Permit $
Zone cubage required . _ , .Plan Cubage
Distance to next nearest building Size of Building Lot
• 4 z
a ,
and for no other purpose.
Addition Repairs No. of Stories
Roof Covering
/
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said bullditig. 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,
pleent,
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 be Performed under this
permit, as are licensed by Miami Shores Village. ( /�r /'
Remarks (Signed) 4.. ._
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-
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 true.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
My Commission Expires
PLANNING BOARD DATE
Chairman 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.
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Owner's Name and Address
Ncw Building YES
To be constructed of Kind of foundation
Estimated Total cost of improvements $ 06 . d0 --
Zone cubage required
Distance to next nearest building. ElGf+7' PEE
Disapproved Date.
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or we plans and specifications herewith submitted for the build
inc 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. _
Zu TOk)
Remodeling Addition
Date
No
whu6r I . 1 :19
12.6 street N. E . 98 11 ST
R egistered Architect and /or Engineer .... ......... It, ....1,...1}.1.,,,_.1 _..
Name and address of licensed contractor —
Location and legal description of lot to be built on: f�
Lot 1 8 Block 11 Subdivision M 1 Ain 1 5 H OQ E ECTIO 0 Owe (\ MEWED
Street and Number where work is to be done 1 25 Jlrt_ .... 57•
TJR . ..._
State work to be done and purpose of building (by floors) 1 „I . TY ._ ' HEp 6i., CQy s $L.(5
and for no other purpose.
Repairs No. of Stories
ucrzers SL.As _........._. 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 un,lcrsiRned 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,
anti has complied kit the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by bins
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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
pcnnit, as are licensed by Miami Shores Village. T
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-
peared
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 Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Mcu,ber iifembcr
Member Member — .._ - - -,-
Council Approved Date Discpprov.: •! Date
NOTE: A charge of $1.00 will be made for making corrections oT changes to this application after approval has been obtained from
the 1'I.rnnir,g Beimd.
A re- m,pection Ice of $1.00 will be charged when such re- inspection is anode necszcsrary by Improper notice for inspectirm or faulty
materials and/or workmanship.
6'X to
Notary Public, State of Florida
to me well known,
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GENERAL CONTRACTORS and BUILDERS
9301 N. E. SIXTH AVE. • MIAMI SHORES, FLA.
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Lot 18, Block 17, AMENDED PLAT MIAMI
SHORES SECTION 1, according to the Plat
thereof, recorded in Plat Book 10 at
Page 70 of the Public Records of Dade
County, Florida.
Order No. 51082 Decl.;14,1960
F. B. # 109348 Scales shown
I HEREBY CERTIFY: That the attached
"SKETCH OF SURVEY` "z , of above describ-
ed property is e andvdcpirect to the
best of my kredge and "11ef as recen
ly surveyed. "and 'platted u* p my direc-
do n.
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A2 r3 INC .
ichard P. Sils Intv �- -�'�.. a Pres.
� Ol Registered Land •Sl. + '#r it O! , 1975
.O 1 State of Florida
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