343 NE 99 St (6)Owner's Name and Address . t ' c -e
Registered Architect and /or Engineer
Name and address of licensed contractor
Permit No..
Disapproved S.?t
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade 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 prpgress of the work.
Date
Building Inspector
ate
Location and legal description of lot to be built on:
Lot Block Subdivision
and Number where work is to be done . .. r .. 3..- ' _ —
State work to be done and purpose of building (by floors) j e`_
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 $ 7 5 Amount of Permit $.
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 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 ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such ors, on work to be performecLunder this
permit, as are licensed by Miami Shores Village.
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 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 foregoing application, and that he did sign the same, and that all facts
therein by him stated ar true.
Date...—...--...—
t N o .
7 iead, Sworn to and Subscribed before me.
to me well known,
Notary Public, State of Florida
My Commission Expires
PLANNING OARD 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 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.
FLORIDA POWER It LIGHT COMPANY
BOX 1900 - MIAMI, FLA. 33101
DATE
OCT 23. iss F
ERAE1Lc.
When receipted, this becomes
your Guarantee Deposit Record.
The terms under which this de-
posit is made and accepted are
printed on the reverse side.
If paid by mail, retain your
cancelled check (when returned
by bank) and this record.
t Y t � 7 -
DEPOSIT
DUETWENTy AND 00 /100 DOLLARS
FLORIDA POWER & LIGHT COMPANY
Payment Received By
E--- PLEASE return attached portion with payment
(C- CUSTOMER C
FLORIDA POWER 8 LIGHT COMPANY) GUARANTEE DEPOSIT RECORD
BOX 1900 • MIAMI, FLA. 33101
APR. 28,
Payment Received By
DATE
196 9
Nor TRAI•; '7:FEPN,B;,E-
When receipted, this becomes
your Guarantee Deposit Record.
The terms under which this de-
posit is made and accepted are
printed on the reverse side.
If paid by mail, retain your
cancelled check (when returned
by bank) and this record.
C FHANIKS i
FOLKS! — 1 ■ :
CUSTOMER
GUARANTEE DEPOSIT RECORD
CASH
CHECK
I X I WP
9'ltiiR1 ".' cCiAppI
34.2 NE 99 ST FRT
MIE�t'I, FLA
SERVICE ADDRESS IF DIFFERENT FROM ABOVE
Ix
air
CASH
CHECK _
1 WP
DEPOSIT
DUE TWENTY —AND 00 /100 DOLLARS
BEATRICE" ZI CCARD I
343 NE 99 ST GAR
MIAMI, FLA
FLORIDA POWER & LIGHT COMPANY
E--- PLEASE return attached portion with payment
No.
.3 3 / .3
ZIP CODE
;7-Y, 196 7)
DATE
No.
ZIP CODE
SERVICE ADDRESS IF DIFFERENT FROM ABOVE
196 L ,
DAT
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