770 NE 98 St (7)Owner's Name and Address
MI SHORES VILLAGE
BUILDIN INS`P'ECTION DEPARTMENT
APPLICAT1'_ iN FOR BUILDING 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 Divi;.inu 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
No '-- -1 Street_
Registered Architect and /or Engineer._. �..�___ a. r_. e 4 _Z t C
Name and address of licensed contractor � __�.. _ -_ Y ..• iLro
Location and legal description of lot to be built on: ff��
Street and Number where work is to be done.
- �Sabdiy lion �� 1 _`l_k_l_ Pt S /4" ° (ZF'3
Lot_ Block
State work to be done and purpose of building (by floors)
Permit No
Disapproved
(Signed)
Chairman
Member
Member
Council Approved
New Building _ Remodeling__ Addition._.- _._ _ ___ __._ Repairs
,---° �r -
To be constructed of C (3 Kind of foundation - Roo Covering__ l f � f� t / f L ��
Estimated Thtal cost of improvements $ . fJ �
1 [ � � Amount of Permi $ g,
plan Cubage_ D -
Distance to next nearest building_ CD I -- -_`- Size of Building Lot
Maximum liVe load to be borne by each floor
1 hereby submit all the plans and ins for said building. All notices with reference to the building and its construction may
p . - - - - it 0 ' gj lJ
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, d 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 notites as are requir'd by the Act. The undersigned agrees to employ only such subcontr, c tors, on woryc to be perform( d under this
permit. as are licensed by Miami Shores Village.
(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 dep� j s and says th he is the __
of the above described construction, that he has e r� read the foretoing application, and that he did sign the same, and that all facts
therein by him stated ar: / / /, //
ead, Sworn to and Subscribed before me.
Notary Public. State of Florida
tor My Com:nission Expires.
PLANNING BOARD DATE
Member
Member
Member
- . -__ _Date Disapproved
A :1 el
and for no other purpose.
00 +
No. of Stories
7 .
to me well known,
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has beta obtained from
the Planning Board.
A re inspection fee of $1.00 will be charged when such re inspection is ma.ie necessary by improper notice for inspeetion or faulty
materials and /or workmanship.
r�