165 NE 98 St (7)Owner's Name and Address, t
p _, t ,
Estimated Total cost of improvements $__________
Zone cubage required
Distance to next nearest building
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
MLAMI SHORES VILLAGE
Disapproved Date
(Signed)
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.
Registered Architect and /or.Engineer
Name and address of licensed contractor_ Z' 0 14 4-e-.1 N
Location and legal description of lot to be built on:
Lot Block sion___ r __
Street and Number where work is to be done �``¢ — ;•
State work to be done and purpose of building (by floors)
a °,
Date
r
No lLar Street
Jr /9N /17rcr....„ tie .
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation 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 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 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. / ��t / / a
Remarks ( Signed) 14, t "' 1 ' it f v f er
Notary Public, State of Florida
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 fi t duly sworn, upon oath deposes and says that he is the
of the above described gbnstruction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hire stated a" flue.
Permit No Date Read, Sworn to and Subscribed before me.
Building Inspector 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.
•
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.
Owner's Name and Address �� �[�9 f. u f f Ir4r No._ __� 4,1" Street K IR 98 z t
Registered Aichitect and /or Engineer Slj Ca- rQr'k
Name and address of licensed contractor a1erKIR __�
Location and legal description of lot to be built on:
Lot Block Subdivision_
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
New Building Remodeling
To be constructed of F M' Kind of foundation
Estimated Total cost of improvements $ $ se_5 0 w___ 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 ,` r ill.; ro �$� s i"
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 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___
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, otary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, being by me first duly sword, upon oath de and says that he is the
of the above described construction, that he has carefiMly read the foregoing application,(nd that he did sign the same, and that all facts
therein by him stated are true.
r
• MIAMI SHORES VILLAGE
'BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date
Permit No
Disapproved Date
( Signed)
Building Inspector
Chairman C
Member
i kke
Notary PubliyF of d
My Commission Ettpire d ed Tb u en n Surety Co. Of M. Xs
LANNING BOARD DATE
.Member
Member
Member
Disapproved Date
Member
Council Approved Date
Date /61.'08 8 19
1 e -S .__J e3 1'11_5_11
KQ ea4 ' r :
_Ss;'rA_
and for no other purpose.
Addition Repairs No. of Stories
• NeQV Roof Covering ittl___!t<__r9i raAr
.') t�
(Signed) __
Read, Sworn to a
7
Subscribed before m
to me well known,
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.