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366 NE 99 St (4)MIAMI SHORES VILLAGE Application is hereby made for the proyal 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____ So , 19.70 Owner's Name and Address__ Q!L,r e.._ a 4 / No 3 Street-47 �' 3 % Registered Architect and /or Engineer. Name and address of licensed contractor__ Location and legal description of lot to be built on: Lot__ Block _ Subdivision . Street and Number where work is to be done State work to be done and purpose of buildin (by floors)- - - 1 Bt .DING INSPECTION DEPARTMENT APPLIr: TION FOR BUILDING PERMIT and for no other purpose. New Building Remodeling Addition_ __ ___.__._ . Repairs__ To be constructed of Kind of -11:• Estimated Total cost of improvements $ / _QS 0 • Amount of Permit $ Zone cubage required _Plan Cubage_ _. Distance to next nearest building___ ___ _ _ ______ of Building Lot___ Maximum live load to be borne by each floor___ I hereby submit all the plans and specifications foi 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, Pennanent 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 performed under this permit, as are licensed by Miami Shores Village. Remarks__ _______ _ STATE OF FLORIDA, COUNTY OF DADE. 1 ss. No. of Stories Roof Covering_ ( Signed). _ aez Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared - -- - - -- 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 � Z. 3 _ ∎_ L"" _ ___.. _ _ Date �_ t- - Read, Sworn to and Subscribed before me. Disapproved } _ Date C. (Signed) l . . - ---- c �!` Building Inspector A My Commission Expires.... ___ Notary Public, State of Florida PLANING BOARD_ __ . DATE Chairman _ __ f Member Member _____ Member _ _- Member . __ . ___._____ ___ __ _ Member Council Approved Date Disapproved NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has brrn obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper not r for in> in or faulty materials and /or workmanship. Date i Application is hereby made for the approyal 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 47-3-7 , 19 Owner's Name and Address__. .d L G____.b • CI 4 i C 6 z t G _._-- - - -_ -- No 3 _._ Street__1!C_E 9 '/ 22/ .rt . ' RegI tered Architect and /or Engineer._. _ Name and address of licensed contractor. . Location and legal description of lot to be built on: Lot% 3 4'`4 Block._ V/ .- _ Subdivision _ Street and Number where work is to be done 4 4 6 IV e ` . 99 State work to be done and purpose of building (by floors )_ rr e Ez rn ✓� \/4 rJ -' 3' Pe — r- -.ci4i eLsc Ft c. L o PG K. C Corrc G 6 .3 4 O cde - S sv� ; , La "` �.tn othe purpose. itset. - -- - - - and for no other p New Building Remodeling ii . - _._ Addition._ __ _. Repairs No. of Stories .... To be constructed of C. 13 ' Kind of foundation Roof Covering.. Estimated Total cost of improvements $ `�d Amount of Permit $ S two 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 fot said building. All notices with reference to the building and its construction may be sent to___ _ /v c /re The undersigned applicant for this building permit doe hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen s Compensation Act, being Section 5968, 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. �? Remarks _ __ _. _ ._. (Signed) STATE OF FLORIDA, COUNTY OF DADE. j 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 Permit No g‘ Date____ f`� _ 7'6 ? Read, Sworn to and Subscribed before me. Disapproved ____ - - - - - - - - - - - - - ( S i g n e d ) ( Signed) _12 Building Spector Chairman _ .. Member Member . Council Approved MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Date to me well known, Notary Public, State of Florida My Commission Expires_ _ - - PLANNING BOARD__ __ _ DATE Member Member Member _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 81.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.