351 NE 98 St (7)MIAMI SHORES VILLAGE
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.
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Owner's Name and Address ___.y /_i __ 1 - ' %/Z, / t
Registered Architect and /or Engineer / 21.1 /' l
Name and address of licensed contractor %•
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
peared
Disapproved Date
/
Date / ,. !
Rea
No Stru
Location and legal description of lot to be built on:
Lot_ _1 y__ /7 Block
' Subdivision_ / . /' i � - - -G� ' . , _ -'''..c2../.__
2' . „ - -- -z_r/ Y t / 1 ' J
and for no other purpose.
New Building Remodeling Addition Repairs No. of S.to Tess
To be constructed of C=.,e._5' Kind of foundation � r? .'_.._l_ -_'L_!._.fi Roof Coverin,g,___�.- w,.
Estimated Total cost of improvements $___ /� 6_ ___�— ___ _Amount of Permit $
Zone cubage required / 4 0 ® — __ _Plan Cubage ' / 6 __�
Distance to next nearest building Size of Building Lot / 0 X / -
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
S ' _ _
be sent to .� „/ - , / ' —' =' 0 , ' f . � � T�_ / ` Y ' / =
The undersigned applicant fof this building permt'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 he posted for inspection on the site of the work such ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perfonnec under this
permit as are licensed by Miami Shores Village
Remarks (Signed) 17
o and Subscribed before
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Before me, the undersigned authority, a no J,a }it publi duly authorized o administer oat •nd take acknowledgments, personally ap-
aE �� r ) VI
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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
thereir, h (J
im stated are true. �/ 6
Permit No Date `
//'. X d Y
N .'y Public, State .f
(Signed) Remy "e, j-• orr G Si'
Building Inspector My Co ission Expires_My___cvrnm1ition b xpires January__16 1950
Bonded by American Surety Co, of Tel Y.
PLANNING BOAR � ' DATE
Chairman _- �e%/_ ember
i
Member {_ Member
Member / � . -- ' � l7 �yt ash 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 workmanhip.
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