216 NE 98 St (2)New Building _ ___ _____ ._ Remodeling
Disapproved _ Da
(Signed)
Building Inspec
Council Approved _
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
/a65 7 - 4/7 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 o other stru ture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Vrllag , F orida, and all provisions of the Laws of the State of Florida, all ord'nances of Miami Shores Village and all rules and
regulations of the Building Division of Miam Shores Village sh 11 be con plied with whether her in specified cr not. A cop" of approv d
plans and specifications must be kept at building during progress of the work.
Owner s Name and Address d __
Registered Architect and /or Engineer __
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot_ _ _ Block _ __ __.__ _ ___ ___ __ __ __ Subdivision_
Street and Number where work is to be done. p _A� aZ - _ / f
State work to be done and pu ose of building (by floors)
- 9 `
Addition.
To be constructed of _ _ _ ._ Kind of foundation _ .___ __ ___ ____ ___ _ Roof Covering
Estimated Total cost of improvements $ ___ _ __ _ _Amount of Permit $ ___- 7 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 h- 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 subcontr •ctors, on ,work to be performed under this
permit, as are licensed by Miar. i Shores Village.
Remarks- - - (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j
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. ___
� .-° - ®__ _ _ Read, Sworn to and Subscribed before me.
.� � (� � _ Date_ _ -
__ ___ Date Disapproved
___ No__ _____ __ _ ___ Street__ _
47/A1/4 ,19.
NNING BOARD __ DATE
Chairman _ ._ __ Member _
Member _ . _ Member
Member _ _ Member _ - - -
Repairs
Notary Public, State of Florida
My Commission Expires
and for no other purpose.
No. of Stories __ _.._._
a ut
____ to me well known,
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- inspectoa 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.
BUILDING ❑ DATE MIAMI SHORES VILLAGE, FLORIDA 19 44C.
ELECTRICAL
PLUMBING ❑ PERMIT N9 7397 Contractor's
License No.
ROOFING ❑
❑ Work to be performed under this Permit_
Building A . Owner of f c..' s O y /rr S f .- C C i- 7 (r �/
/
Architect / /7C .
Contractor
or Builder 4 ' 5 ` t � ;: k _ CO A •Z si a 1 "+ • L , 44 ! 7'
Legal Lot subdi_
Description 11 Bl vision
1
Building 7 i t t - (, II Value of 11 Amount of �`�
Address of
Project $ I Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statemen or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. t y
CONTRACTOR OR BUILDER BY
Signed. ( L ( i�4- INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compiianc all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper au o -s of Miami Shores Village. In aa>
cepting this permit I assume responsibility for ell work done by either, myself, ray agent, servant or employee.
AUTHORITY
A••OT
STATE OF FLORIDA,
COUNTY OF DADE.
Before met t e unfersi
peared
Permit No ,
Disapproved ____ _
(Signed)
Chain' nan
Member
Member .
Council Approved
Street and Number where work is to be done
SS.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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_ SO I 2 -) k. ..
Owner's Name and Address A3 No._ ------- Street..
Registered Architect and/or Engineer.
Name and address of licensed contractor_ 4 t vki i At
Location and legal description of lot to be built on:
Lot._ Block Subdivision
2- •
State work to be done and purpose of building (by floors)... ( LACIAT_IW.%.__Ii. Fe IS Vt. . O5 .. caFm..E. _Aor lrtittc:-' _Ns LA.Kkt,:riki) ",
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation. Covering__
Estimated Total cost of improvements $ 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 fot said building. All notices with reference to the building and its construction may
be sent to tj %1:e4,,cLic, &a,
The undersigned applicant for this building permit dot hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen s Compensation Act, being Sec:ion 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 fo inspection on the site of the work such public tice
or notices as are required by the Act. The undersigned agrees to employ only such contr ctors, on work to J performed und this
permit, as are licensed by Miami Shores Village.
Remarks__ _ _____ (pried
ed au ority, otary public, t ly authorized to administer oaths and take acknowledgments, personally ap-
‹.
and who, being by me first duly sworn, upon oath deposes and says that he is the C.ISAlik,ac.
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.
Date
pate /
Building Inspector
* °
... •
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires__
to me well known,
PLA N1NG BOARD_ DATE
Member
Member
Member
._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.