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.