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28 NE 98 St (3)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. STATE OF FLORIDA, COUNTY OF DADE. j ss ' MIAMI SHORES VILLAGE Estimated Total cost of improvements $ Zone cubage required_ Distance to next nearest building S i z e of Building Lot Maximum live load to be borne by each floor Disapproved Date_ ( Signed) (Signe Date ,R1 L c / , 191E Owner's Name and Address __EC?Ie�2J�L_I7�a✓�)_711 No.___. E Street___e__ • `I8 S _R --- 1 ---- 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 State work t be done and purpose of building (by floors) ____ L / (.1l9 ©Z D (__1 /Y / I_Q and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of f u n d ation R gf Caering 0 • _Amount of Permit $ •� __plan Cubage 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, Compile • - neral Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance fr, all , ontractors or sub - contracts employed by him in the work to be performed under this permit; and will post or cause to be post • : for insp ction on the site of the w. such public notice or notices as are required by the Act. The undersigned agrees to employ only h subco, . ctors, on work to bererformed under this permit, as are licensed by Miami Shores Village. 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. 3 5L Permit No __ Date 21- Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspectoj My Commission Expires NING 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 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. Owner's Name and t - 1 C--- .....P i ca - -EC-L-1.. No i ...... Street-- C- _l T Registered Architect and /or Engineer ,,., .. .... . .........,<- .,,,,,.- ..n,,,,, - -. Name and address of licensed contractor . c.-4----. siclf:E- Location p d legal d' cr' tion of lot to be built on: Lot z Z� 1" Block 7 S ivision -- �! _ ......... ...,,,� Street and Number where work is to be done ' . ° // _.._._ _ _ _ — __ _ ..... l State work to be done and purpose of building (by floors)... ___i.6? . ^_...K. I- C' C CRaC.— _....P L _-__..___.._. Disapproved (Signed) L /4 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT /L Date.. Chairman Member Member ...... and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof _Covering _..^ Estimated Total cost of improvements $ Amount of Permit S. 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 pennit 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 hint in the work to be performed under this pennit; and will post or cause to be posted for insp ection on - he work such public notice or notices as are required by the Act. The undersigned agrees to employ only such su acto s, o• o to be performed under this pennit, 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 fojegoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. 5 3 3 Date r ' / Read, Sworn to and Subscribed before me. Notary Public, State of Florida Build mg Inspector ,' \ J My Commission Expires 1 PLAN 'NC BOARD \ DATE Member Member Member to me well known, 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 rc- in>pcc•tion fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.