372 NE 98 St (2)BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING LDING 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.
19.7 )
I Date.. ..__.._........._ / .
1 ...tee _ No.., ..1... ...__.. Street 4 9 S 5
Registered Architect and /or Engineer '^ S. -c_ 4^ ltJ, Fj a i ) S..._ ,.
. _
Name and address of licensed contractor G,... c-4.17 -- c.-.141. r• hi 4, 1 I
Locatiuq and legal descript n of lot to be uilt on:
Lot C•l 4- E Y2-1 , bfi 3 Block ` Subdivision..... -
i ce , 1 - -52,�: .f. ._._
Street and Number where work is to be done 3 7 �r Ili /- - S / — - - -- —
pl<� ,_ 7 ,.- b 0 ci V
Owner's Name and Address /
State work to be done and purpose of building (by floors) T 5.0 G fl
f wts � G ✓a
.and for no other purpose.
New Building }} Remo cling 1 Addition Repairs No. 7 off ,Stories
To be constructed of .��GS /c rJ'uak(ind of foundation_..... ^- ,c.. Roof Covering ..... /...i... t ................._.
Estimated Total cost of improvements $ 75-0 . 0 0 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 public notice
or notices as arc 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. -
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 are true.
f Dat
7 .L .._ ead, S orn to and Subscribed before me.
_. � :
5 L✓
Disapproved ___ ...__ . � D. to
(Signed)
Building In
MIAMI SHORES VILLAGE
Chairman
Mcrnbcr
Member .....
Council Approved Date
NOTE: A charge of $1.00 will be made for making corrections
the Planning Hoard.
A re inspection fee of $1.00 will be charged
materials and /or workmanship.
PLANNING A4ARD DATE
Member
Member
Member
Disapproved
to me well known,
, Notary Public, State of Florida
is\ Expires
Date
or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty