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310 NE 98 St (5)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. Owner's Name and Address____ Registered Architect and /or I ngineer r Name and address of licensed contractor ,' •■(1,/ / Location and legal description of lot to be built o STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT BUILDING INSPECTION DEPARTMENT Date_ eo • , 19. _____ No. _�____�� Lot__._w_____ _______ Block___ ___________ _ Subdivision s � Street and Number where work is to be done State work to be done and purpose of building (by floors) V 1 / 'J f`"° -and for no other purpose. New Building ____________ Remodeling_ __ Addition Repairs No. of Stories____- ________ To be constructed of Kind of foundation o F..o lcri _ ____�_ Estimated Total cost of improvements $______ —_ Amount of Permit u_ Zone cubage required__ Plan Cubage Distance to next nearest of Building Lot _ Maximum live load to be borne by each floor 1 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 - 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. . t , Remarks (Signed) �L �' � , 6. { ' � f1 r .t r "� 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 caref lly read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No._ ° _____.____ Date_�_ 17/i _ Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Notary Public, State of Florida Building Inspector My Commission PLANNING 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 faul materials and /or workmanship. 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. 6/� d / Owner's Name and Address_..__ Registered Architect and/or gineer_ —____ Name and address of licensed contractor Location and legal description of lot to be built Lot____________________ —_ Block_______— _______ Subdivision___ Street and Number where work is to be done 3 / a State work to be done and purpose of building (by floors) T be td f Zone cubage required___ APPLICATION FOR EIJILDING PERMIT MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Disapproved �_________________________ Date________ (Signed) Date New Building Remod ing Addition Repairs No. of Stories R oof eying To e construe e o Kind of foun ati n J - Estimated Total cost of improvements of Permit $ _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 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 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (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 and who, being by me first duly sworn, upon oath deposes and says that be is the of the above described construction, that he has carefjtlly read the foregoing application, and that be did sign the same, and that all facts therein by him stated ar true. Permit No 2 &3 _— Date__ 2 ° —J,/ --_ Read, Sworn to and Subscribed before me. Building Inspector My Commission Expires_ ' PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved — Date Disapproved Notary Public, State of Florida , 19 —___ No._______________ Street______ _ ________ and for no other purpose. 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- inspection fee of $1.00 will be'cbarged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. .,