285 NE 98 St (2)Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
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 regula-
tions 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.
IA‘i
I
Registered Architect and /or Engineer 1/
Owner's Name and Address
Name and address of licensed contractor___
Location and legal description of lot to be built on:
Lot 2 i
Street and Number where work is to be done
MIAMI SHORES VILLAGE
'WILDING INSPECTillk DEPARTMENT
/ APPLICATION FOR WILDING PERMIT
/
,
� �,n d
y�� .\ (. No.__ Street__
to be done and tlrpose,of building floors) � r`° _ 4'
Block__ _!__ Subdivision
__and for no other purpose.
New Building Remodeling____ Addl'tion Repairs No. of Stories___
To be constructed of___ _ 2 a_ K f 4oundation _ _!` - _ 0
6 . Estimated Total cost of i ovements $_ — ,_Amount of Permit $ __.
Zone cubage required (-) C ,) ^ _,Plan Cubage______________°_ _ _ _ o
Distance to next nearest building_____ C�__6_ `°_______________ Size of Building Lot ___.,[_____2, — _ J_,L_ —
Maximum live load to be borne by each floor
I hereby ,
s bmit all the plans a specifications for said building. All notices with reference to the building and its construction may
be sent to ���� r L ,:` , '0 'yob) it ri 1'2'' `) (`'.7a
l � � l�> > 'y � o
The undersigned applicant for this building permit does hereby certify that be 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 subs on } rk tg, errrr}ed under this
permit, as are licensed by Miami Shores Village. ` ' //�, �ll� 1_�
Remarks (Signed) ,
STATE OF FLORIDA,
COUNTY OF DADE.
and who, bein
of the above
therein by hi
Permit No.
Disapproved
(Signe
Chairman
Member
Member
Council
4 ,Rzob Covering___
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
first duly sworn, upon oath deposes and says that be is e____
. constructionohat he has carefull read ..e foregoing -' p and that he did sign
ed/ are xue. / (L
_ Date '
Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
Notary Public, State of Florida
JA'r '��i s
to me well known,
the same, and that all facts
PLANNING BOARD DATE
Member
Member
Member
_Date Disapproved
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.
1