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307 NE 99 St (10)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 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 Address • MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Registered Architect andior Engineer (/Name and address of licensed contractor APPLICATION FOR BUILDING PERMIT Location and legal description of lot to be built on: !}� Lot /J / 1 Block T Subdivision (, I e f9 tree( and Number where work is to be done 3 v State work to be done and purpose of building (by floors). state exterior colors (submit samples) and for no other purpose. New Building Remodeling Addition To be constructed of Kind of foundation Roof Covering i mated Total cost of improvements S (/ C/49 Zone cubage required Plan Cubage Distance to next m Size of Building Lot Maximum live load 1 hereby submi The undersigned Compensation Act, compliance from al on the site of the a under this permit. Remarks (Signed) STATE OF FLORIDA COUNTY OF DADE. } ss. Before me. the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments, personally appeared 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. Permit No. Disapproved (Signed) So 77/ C Building Inspector lg. All notices with reference to the building and its construction may be sent to :ertify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's )f Florida. Permanent Supplement. and has complied with the provisions thereof, and will require similar him in the work to be performed under this permit: and will post or cause to be posted for inspection ,fired by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed Date //, /f/ Date 1/M17 j) 3 c 13 s'41.?' Repairs Na of Stories Amount of Permit $ ✓ / ' Read. Sworn to and Subscribed before me. Date /,/ //l 19 o �� 7 Street ,e, Notary Public. State of Florida 7,51— fa 65 My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and workmanship. Chairman Member MIAMI SHORES VILLAGE 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. Date - - - -. - -�__! U__(r_l1 _ �T , 19 6 to Owner's Name and Address__ �iS___._..e3�___ �_ No._..3 L�___7_____ Street Ai E Y Registered Architect and /or Engineer Name and address of licensed contractor 49 t-' 'J 1 — Location and legal description of lot to be built on: Lot_ Block Subdivision Street and Number where work is to be done_ ___ 3_Q__2 /U __ 1 State work to be done a.. purpose of ' uilding (by floors) ____ and for no other purpose. New Building Rem • : eling Addition Repairs No. of Stories To be constructed of Kind of foundation Estimated Total cost of improvements $ 6 /06 C Amount of Permit $ Zone cubage required____.__ _Plan Cubage_ 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 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 -con ctors 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 t work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work t. be performed under this permit, as are licensed by Miami Shores Village. Remarks_______ 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 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 forgoing application, and that he did sign the same, and that all facts therein by him stated are „tr}ye�,/� Permit No _ Date Read, Sworn to and Subscribed before me. BUILDING INSPECTION DEPARTMENT Disapproved ' Building Inspector PLANNING B o RD (Signed) Member Member DATE C overing to me well known, Notary Public, State of Florida Commission Expires 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.