399 NE 98 St (4)Application is hereby made for thc nppro\•al of the detailed statement in the plans and specifications herewith submitted for the build
inc 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 thc 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.
Owner's Namc and Address .
Registered Architect and /or Engineer
Name and address of licensed contr
Location and legal description of lot to be built on:
Lot Block Subdivisionn _..__
Street and Number where work is to be done. �!� sa� � ,, .. __.. _ - - ---
State work to be done and purpose of building (by floors 17-- ....'�Y. . ..... _ ..._ f.Y�kf .. .._...
Ncw Building
To be constructed of Kind of foundation R oof Covering
Estimated Total cost of improvements $ .Cv • 0 b Amount of Permit & 1 "r a�
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 crrtify 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, PermAnt•nt Sup sleurent,
and has complied %%oh the rovisions 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, op wor to be pee form 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.
Permit No.._.... j ad ( 4 , Date A ca
Disapproved
(Signed)
APPLICATION FOR BUILDING PERMIT
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Building Inspector
ate
Chairman
Member
Member _....._......_..._. �...._
Council Approved Date
NOTE: A charge of $1.00 will be made for making corrections
the Plennir.g Board.
A re- inspection ice of $1.00 will be charged
materials anti /or workmanship.
Date......_... _ _.__._ ..._.__........ ,19..9
7J a tr . 7? -f-,-P
and for no other purpose.
Remodeling L Addition Repairs No. of Stories ..2.
PLANNING BOARD DATE
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
to me well known,
Member
Member
Member ...._
Disapproved Date
or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection otr faulty