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1963 SIGNApplication 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 Addres Nev. To I. Esti Zonc Dist. Max be Remarks PORTR 'TS PAINTIN SCULPTU FINE PRIN STATE OF FLORIDA, COUNTY OF DADE. Permit No Disapproved ( Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT SS. Registered Architect and /or Engineer Name and address of licensed contractor __ ___ /�`7f/C Location and legal description of lot to be built on Lot Block Street and Number where work is to be done State work to be done and purpose of building (by floors)_ Date -_ Subdivisio PETER DRIBEN LOUISE KIRBY Date , 19 Street and for no other purpose. Repairs No. of Stories Roof _Covering inount of Permit $ zn Cubage ze of Building Lot ANTIQUE 214 NORTHEAST 98TH STREET RESTORING MIAMI SHORES. FLORIDA ORIGINALS TEL. PL. 9 -4091 CREATIVE FRA NG ARTIST'S SUPPL S ° © . ART WORKSHOP, tify 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 ontractors or sub - contractors ployed by him in the work to be performed under this permit; and will post or cause to be posted for in ction on the site of t work uch publ' notice or notices as are required by the Act. The undersigned agrees to employ only such sub .. tractors, on work e fo ' ed u .e', this permit, as are licensed by Miami Shores Village. P■ll notices with reference to the building and its construction may (Sign4 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 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. Read, Sworn to and Subscribed before me. Notary Public, State of Florida uilding nspector 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.