55 NE 99 St (10)APPLICATION
Application is hereby made for the approval of the plans and
specifications herewith submitted for the building or other
sturcture herein described. This application is made in com-
pliance and conformation with the Building Ordinance of the
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 Department of
Miami Shores Village, shall be complied with, whether specified
or not
AIM - J • OWNER _5 !... ... , /_...
I.i4111i.0
ARCHITECT / / G� L91
CONTR
LOT /ppL f /? BLK SUBDIVISION
NEW //ADDITION REPAIRS
COST (excluding Archtitect's
Building to be used for
I hereby submit all the plans and
STA'L'E OF FLORIDA)
COUNTY OF DADE )
Before me, the undersigned authority, a notary public, duly
authorized to administer oaths and take acknowledgment, personally
appeared to me well known, and
who, being by me first duly sworn, upon oath deposes and says that
he is the builder of the above described construction, that he
has read the foregoing application, and that he did sign the same,
and that facts stated by him are true. Read, Sworn and Subscribed
before me,
My Commission expires
Cubic Feet
Chairman
Member
Member
Secretary
Permit No. M Issued to
Electrical Permit No.
BUILDING PERMIT - RECORD
MIAMI SHORES VILLAGE
FLORIDA
fee,
N UMBER
OF STORIES
Notary Public(Signed)
%4 Cubic feet required in this Block
PLANNING BOARD
Building Inspector
Plumbing Permit No.
DATE � • // 2432
LLL �
ROOF
landscaping & garage )$ Q5"S p o'
nd no other use.
specifics s fo said ilding.
Signed
Date ��-1i