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895 NE 98 St (5)4. APPLICATION 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 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. Registered Architect and /or Engineer - Name and address of licensed contractor Location and legal description of lot to be built on: Lot__ O2 t G� Block 7 Z Street and Number were work is to be done STATE OF FLORIDA, COUNTY OF DADE. ss Permit No Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Owner's Name and Address_ ,,,hc Subdivision State work to be done and purpose of building (by floors) Date T )4✓_-!_ 41 Syr} 1J✓�i/�� Size of Building Lot O tL . a No, Street _t_7• , ,7 t ? C•v New Building L .. , Remodeling Additi Repairs No. of S es.._ .../ To be constructed of ° • s Kind of f undation .. Estimated Total cost of improvements $ /' -, .' ' O9 D Amount of Permit $ etri e - oof Cove ' g 7 3�' / Zone cubage required ✓ �1 � plan Cubage a - -� 2. Z Distance to next nearest building____. 54 Maximum live load to be borne by each floor I hereby submit all the plans and specifications fond buii�cjipg. All notices with r�fergnce to the building and its construction may be sent to OS and S and for no other purpose. The undersigned applicant for this building pennit 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 sue >lie notice or notices as are required by the Act. The undersigned agrees to employ only such eeplra ors, on work to be perfo ryf , nder this permit, as are licensed by Miami Shores Village. Remarks____ _ (Signed) 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. Dat:__ C { ■ ■w __.: Read, Sworn to and Subscribed before me. Notary Public, State of Florida Buil• s p ec toor My Commission Expires to me well known, PLANNING BOARD DATE Chairman 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. 3 aygi, Slit; 19`9 ' 1 0 © '� (41) '5" t 't 6 G V o %Si . 2.3 1 g /t )4 vci t z ft gc31 Vootc4I I,pr 199 , • 241 V'Ic 4' 1 " ", 11 ! 1 ` 14.ifft 131 (C3-"T' e •44 • 0 `,t4, 24)-er.€3 adet e Q• "wcaz ° RAT 't t+ kc2 • : 21 GA.047.-st cot' GeAtai