146 NE 98 StPermit No
Disapproved
(Signed)
MIAMI 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 building
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 regula-
tions 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.
•.srly
Date
/W WN
oa
Date_
f�-
Owner's Name and Address �/ • � � L � No.. trzet_a_L. •
S 2_ •
Registered Architect and /or Engineer_—_
Name and address of licensed contracto
Location and le 1 description of lot to be ilt on:
Subdivision ' �•
Street and Number where work is to be done__
146 N /._ f11!',5r _
State work to be done and purpose of building (by floors)
__and for
New Building_ e ....- Remodeling A tion Repairs No. of
To be constructed of____el l ! Kind of foundation Roof Covering_!
d �+ 00
Estimated Total cost of improvements $___LJ __ __Amount of Permit $
`,�
Zone cubage required ° l » t% c __Plan Cubage_ d1}
Distance to next nearest building Size of Building Lot /
Maximum live load to be borne by each floor
I hereby submit
the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to ?A / .-6___9
Date Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
J 197
no other purpose.
Stories_
undersigned applicant for this building permit does hereby certify that be 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 - cony :ractors 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 to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that be is the
of the above described construction, that he has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
Building Inspector M Commission Expires
PLANNING BOARD 2 DATE ,
Chairma 4. .;. . Member r ILA
...0 � / � Member
, �
Member �� � L �+-�• � .
Member _' rA4f r Apr._ Air Member
Council Approved Date Disapproved _Date
NOTE: A charge of $1.00 will be made 1.. 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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