130 NE 98 St (5)Owner's Name and Address , ®C
Registered Architect and /or Engineer
Sheet and Number where work is to be done
New Building
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed statess nt or ine plans and specifications herewith submitted for the build •
in 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.
Geossa
54 4i F.
...._sass_
To be constructed of ' C Kind of foundation C eve k -�
The undersigned applicant for this building permit does hereby certify that he understands and
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General
and has complied with the provisions thereof, and will require similar compliance from all contra
in the work to be performed under this permit; and will post or cause to be posted fo pectio
or noticcs as arc required by the Act. The undersigned agrees to employ only s tract
permit, as are licensed by Miami Shores Village.
Remarks..._ (Signed)
} ss.
Date
Chairman
Member
Member .. .. —
Council Approved Date
Date... DE- . �..__....._ ..
._ No....! 3_ _.._... Street—.. S Y .
PLANNING BOARD DATE
!.f.f 7111 •••f.1
Name and address of licensed contractor vkii 14 E. :.._.. ...._...�. �_...
Location and legal description of lot to be built on: btJ SV eO CI' °C LET' 9 Lerfi 10 0 ti
Lot Block Subdivision
State work to be done and purpose of building (by floors)._ FO CE c �k.......
_........... for no other purpose.
Remodeling Addition Repairs;
Roof Covering
Estimated Total cost of improvements $ 5OCS Amount of Permit $. xt"01
Zone cubage required _._.._...plan Cubage
Distance .to next nearest building. 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.
sass ...
STATE OF FLORIDA,
COUNTY OF DADE.
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
thcrcin by him stated are
Permit No.._ / X � Date ....l t1. ?J......_._._ Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Notary Public, State of Florida
ut ding Inspector My Commission Expires �...._ _........._.._..�_r
Member
Member ...
Member — . _.._.....—.
Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has
the Plannir.g Board.
A re-inspection fce of 31.00 will be charged when such re- inspection is made necessary by improper notice for
materials and/or workmanship.
No. of Stories
ccepts his obligations as an employer
s of Florida, Permanent Supplement,
or sub - contractors employed by him
e site of the work such public notice
work to be performed under this
to me well known,
been obtained from
inspection or faulty
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THESE PLANS ARE APPROVED FOR
ISSUANCE OF A BUILDING PERMIT
VARIANCE(S) LISTED IN "REMARKS"
MIAMI SHORES BUILDING AND
UNLESS SPECIFICALLY LISTED
AND COUNTY LAWS MUST BE COMPLIED
Author e6 S'Rragture
ZONING
BELOW.
Date
• WITH NO VARIANCES • WITH
NO OTHER DEVIATIONS FROM THE
ORDINANCES WILL BE PERMITTED,
ALL OTHER APPLICABLE STATE
WITH BY ALL PARTIES.
FIRE DEPARTMENT J
PUBLIC WORKS
POLICE DEPARTMENT
BUILDING DIRECTOR
PLANNING &, ZONING BOARD —
I
VILLAGE COUNCIL
APPROVAL
PRELIMINARY: MALs
REMARKS:
COMPLI ^..:CE .: T..:E SOUTH FLORIDA BUILDING CODE AS MOPED
6i! MIAMI SHOE 'AI9.AGE IS REQU:: ?FD. THE ARCHITECT, I ILBER
VS CONTRAd:T07 • : P "' :'•.• ; •�•' It "QWI.Fi3GE OF AR 131110.
IA WHETHER OR NOT SPECIFICALLY INDICAie HEREIN.
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