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165 NE 98 St (4)Disapproved __ _ __ _________ Dat (Signed) !L ` l- � Building Insp ctor 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 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. Date Januery 12 , 19 71 .'S 0 ® i7:^.J-ser No 165 .Street 9th© 9Gth. ti�'ri9'Oe li Owner's Name and Address 1 ' o L= Registered Architect and /or Engineer. 1 Ciaa..l Ui".°.�i ' 111C oT�S Inc . 1 002 0 24th G0 9 Hialeah la 0 3301 - 3 Name and address of licensed contractor__ � a Location and legal description of lot to be built on: Lot__. Block Subdivision Street and Number where work is to be done 16 5''ny'0 98th. 5 treott -� �°r'10V3 13 3X .S tin � staeJ. c as 3ment �:J''•_ndo s c.nc State work to be done and purpose of building (by floors)____.. � - _ i a s j cs. install 13 aluminum a:m�.n,, type tir.x�.dor. :O structural ch2n and for no other purpose. New Building Remodeling iC.0 Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ 110000 7000 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 Calumet Windows . : c. a 1002 .G. 2b.ch. ` -to ilia .cah : ='J a® 33 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 5968, Compiled General Laws of Florida, Pennanent Supplement, and has complied with the rovisions 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 f% nspection on e site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only suc• su. one - ctors, .n work to be performed 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 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 1 Date.___. _ - - Read, Sworn to and Subscribed before me. 7 Amount of Permit $ Council Approved __Date Disapproved to me well known, Notary Public, State of Florida My Commission Expires__ PLANNING BOARD_. __ _ DATE Chairman Member Member Member Member .. ____.. ___ _. Member 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.