28 NE 98 St (2)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, whe .: rein s. cified 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 _
Re Architect and /or Engineer
Name and address of licensed contractor. Le__) E IDA
Remarks
Chairman
Member
Member .
Council Approved
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Location and 1,g des 'ption of lot to b built on:
Lot 71' 2C___. Block Sub ' i on i 7
®
Street and umber here work is to be done._ C� . _ r____c__- ___ .'T��?
State work to be done and pure se of l uijding (by fl rs )._ — . .E ._
New Building .___ Remodeling.. ____ _._ Addition
To be constructed of Kind of foundation_ f Covering_
Estimated Total cost of improvements $
Zone cubage required
Distance to_ next nearest building_ . .
Maximum live load to be borne by each floor_._
Disapproved ____ _ __
„ _______ Date
( Signed) C.a. >
Building Inspecto
PL NING BOARD_
._Date
NOTE: A charge of $1.00 will be made for making corrections
the Planning Board.
A re- inspection fee of 51.00 will be charged
materials and /or workmanship.
T
( Signed)
Date
.Amount of Permit $ ` 1
My Commission Expires..
DATE
and for no o er purpose.
Repairs_____________________ ____ No. of Stories
.Plan Cubage____ _.
Size of Building Lot
I hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may
be sent to.._.-
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, Pennanent 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 sgch subcontractors, on work to be per i)ned under this
permit, as are licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. ss
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 fta� a�e�e.
_____7'___
Date... 2 — 7—
Permit No. Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Member
Member
Member
Disapproved
or changes to this application after approval has been
7 e
19k4/..
Date
obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty