245 NE 99 St (15)Location an le al des iption of lot to be built on:
Lot °/ /. 7Block
Street a d Number where work is to be done
Permit No
Disapproved
(Signed)
MIAMI SHO-
$ to work,to be done and purpose of building (by floors)___
p a
r;3 -(4,6/ ,building
INSPE
New Building Remodeling
To be constructed of_ Kind of foundatisr
Estimated Total cost of improvements $ / — —
Building Inspector
r
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
therein by him shed arrp, e.
7
VILLAGE
EPARTMENT
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 at building during progress of the work.
k � � Q 6 1 '`'' 4 y �� ' �' Date Owner's Name and Address._. . '� No
l
,1'
Registered Architect and /or'Enginee� • � ._: J � -`
Name and address of licensed contractor — 'Q__ -__ -. _- Jc_]f ( f ?
Street. /9
Subdivision- '/ f Q . ' e s
-- - ��%s",.L- l '�. <•���
- 4 )- €'> Rpof Covering
D e Read, Sworn to . nd Subscribe before me.
19
e r
4 ' l - (c �l LLV' 'an�or no other purpose
Addition ' Repairs 1 No. of Stories
G
Amount of Permit $
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
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,
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 inspectio n the site oftheork sucl ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontract , on w k>�to be perfp under this
permit, as are licensed by Miami Shores Village.
-/-
Remarks (Signed) � ''�%) `�
/ '
STATE OF FLORIDA,
COUNTY OF DADE. J ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
t he did sign the same, and that all facts
Notary Pu • lic, Sta • of Florida
My o ''- '. Expi es
PLAN NG BOARD DATE\
Chainnan 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.