857 NE 98 St (16)Disapproved ... t. Date.
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby Londe for the approval of the detailed statcsuent ut ore 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 Itfiami
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 iuilding 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 Name and Address 627V _ No.... 7 .i Street_L&
Registered Architect and /or Engineer „ ;,, „,,,,...•.•,,,
Name and address of licensed contractor
Location and legal description of lot to be built on:
...
Lot l ... D Y Block 7 Subdivision 1
.... .. .bdi i ' `
...,1 ...._..._
Street and Number where work is to be done c ? . . � 1\) F 9 e 5
State work to be done and purpose of building (by floors) - ....._. c41-0 :...... L �...
_.._._ and for no other purpose.
Ncw Building Remodeling. Addition Repair; No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 1,e? `... ® Amount of Permit 5.re1:
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 perrnit does hereby certify that he understands and ac
of labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Law
and has complied with the provisions thereof, and will require similar compliance from all contractors
in tl•c work to be performed under this permit; and will post or cause to be posted for ins ction on the
or notices as arc required by the Act. The undersigned agrees to employ only such subcor actors,. o: w
pcnnit, as are licensed by Miami Shores Village.
Remarks
Building Inspector
ti %a►Z�
(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 gq stated
a a true.
Permit Date.../ .l r t Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires _
PLANNING BOARD DATE
Chairmen Member
Merr,ber Member
Member .. .. _ _...._......_..._.— ...._....... Member
Council Approved Date Disapproved
NOTE: A charge of $1.00 will be madc for making corrections or changes to this application after approval
the I'lannir.;; Board.
A re-inspection fce of 31.00 will be charged when such re- inspection is made necessary by improper notice
materials and /or workmanship.
–
opts his obligations as an employer
o Florida, Permanent Supplement,
s b- contractors employed by him
t'e of the work such public notice
to be performed under this
to me well known,
Date
has been obtained from
for inspection or faulty
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 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 Name and Address 'if' c-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 building (b floors)
Lf )e 2 - ea--e 4<t4 te--- - /
STATE OF FLORIDA,
COUNTY OF DADE.
}
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
ss.
Date
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
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 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, 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 subcontract rs, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) �!
No. . !'
Street .._.rN. s.
,
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 Date Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chainnan Member
Member Member
Member Member
Council Approved 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
V 7