895 NE 98 St (12)MIAMI SH ES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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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.
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No '
y: - r Street 2/ 7 ,71 ,71 '
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Registered Architect and /or Engineer._... - 7:4;e s t
Owner's Name and Address ._.0 - ` ,;9/47, " t
Name and address of licensed contractor.._
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done_
State work to be done and purpose of building (by floors)._ . x�
New Building ::2 __ _.____. R ._
To be constructed of 6 Kind of
Estimated Total cost of improvements $ '
Zone cubage required
Distance to next nearest building...
Maximum live load to be borne by each floor___
I hereby submit all tyeplans a spe
be sent to__. _ - '- - (_ 7 `
The undersigned applicant for this building permit does herei4' certify at he understands and accepts his obligations as an employer
of labor under the Florida Workmen s Compensation Act, being Sectj6 966, Compiled General Laws of Florida, Pennanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - co ntractors employed by him
in the work to be performe under this permit; and will post or cause to be posted for i ion on to the work su ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such s ntractor on or to be perfo a under A 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
Permit No
Disapproved
(Signed)
Date___
Building Inspector
foundatioa j 0'''>`` Roof Covering
Amount of Permit $ �.,p
flan Cubage___. rs-7 ' co C+J•
Size of Building Lot_
ons for said building.
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Date • U
Chairman
Member _.... _ .
Member . ._
Council Approved
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
Subdivis' 1_= ?
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= " /'- --
PLAIXNING BOARD._ __ .
.Date
• Date
and for no other purpose.
Addition__ _._ Repairs No. of Stori s._.. rt
s with reference to the building and its construction may
to me well known,
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires...- _
DATE
Member - -
Member
Member .. _ _.. _
Disapproved Date
making corrections or changes to this application after approval has brim obtained from
when such re- inspection is made necessary by improper notice for insp., tion or faulty
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