1249 NE 100 St (3)BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING . PERMIT
Applkttion is hereby made for the approval of the detailed statement oi ine plans and-specifications herewith submitted for th b .
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 thc Laws of the State of Florida. all ordinances of Miami Shores Village and ill and
regulations of the iloilding Division of Miallli 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 4 j ft
-
Registered Architect and/or Engineer --
Name and address of li ./
censed contractor O/JA.) e n ai 0.-24 5
P=6 ` " '/ dootfo
Location and..legal description of lot to be built on:
Lot.. mock__ I. Subdivision.
Street and Number when: work is to be done
State work to be done and purpose of building (by floors) /A) 5 7 a.,t e 2, A /A j s
New Bui!ding.. RemodCling Addition. Repairs. No. of
To be be constructed of Kind of 9undation.— — Roof vexing
Estimated Total cost of improvements $ a-3s.,LS 0 Amount of Perrnit 1 gir)
Zone cubage required 0.0■D 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 uilding. All notices with reference to the building and its construction may
be sent
Te undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
oi labor under the Florida Workmen's Compensation Act. being Section 5066, Compiled Ceneral Laws of Florida. Permanent SiliTleinent,
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 bc 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 hy the Act. The undersigned agrees to employ only such subc on work to be performed under this
permit. as are licensed by Miami Shores Village.
Reinarks (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
Disapproved --
(Sizned)
•
MIAMI SHORES VILLAGE
to me well known,
and who. being by mc 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 e true..
Permit No.. c Date. )1114 Read, Sworn to and Subsaibed before nie.
. Date—
Building Inspector
Date /
StreetL. itoo
•«•■•••■•••••••“”i•••••••••••••••••••,•••••••...............,
Notary Public, State of Florida
My Commission Expires
and for no other purpose.
- • • • • • - N ..... • • ..... . • •
PLANNINC BOARD..-- MO WM. •■■••••••■••• DATE
Cnairinan .._.... — . Member
M ember ..... ..... -....- • ••■••• • NI ember
Member Member
Council Approved _ — Date Disapproved ....... Date
(3 A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained front
the Plannir.;.: num&
A re.impection f ce of 11.00 will be charged when such re-inspection is made necessary by Improper notice foe inspection or faulty
materials anu/or workmanship.
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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.
and who, bein g
of the above
therein by him
Permit No
Disapproved
(Signed)
rcTl
APPLICATION FOR BUILDING PERMIT
Date
Date
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
l�
Owner's Name and Address.... 6_ lI v 55. .
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 (by floors)
New Building Remodeling
To be constructed of Kind of fo
Estimated Total cost of improvements $..
/ - 7` a',. G - ■
Addition Repairs No. of Stories
ation R Covering
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 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 such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under 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
by me first duly sworn, upon oath deposes and says that he is the.
described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
stated are true.
(2..
Date
Amount of Permit $.. L
LL 19.
No /)- tt . 9 Street /i t /ay . '
? -o3 /24) Z � �
L c2 SDI
to me well known,
Read, Sworn to and Subscribed before me.
and for no other purpose.
Notary Public, State of Florida
My Commission Expires
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.
ti •
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
STATE OF FLORIDA,
COUNTY OF DADE
APPLICATION FOR BUILDING PERMIT
Council Approved
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Remarks
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__.1.,_ ' .4 (
State woo t done and p ose of building (by floors )_f
Distance to next nearest building
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 s ntrractors rk 4o be performed under this
permit, as are licensed by Miami Shores Village.
�
and for no other purpose.
New Building L 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
Size of Building Lot
(Signed)._
Date ::1 ' % ` 19
'No Street
gJt-t Zz;70
Before me, • , undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, tlein by me first duly sworn, upon oath deposes and says that he is the
of the abo e de cribed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by trim s' tech -are true.
Permit No.,, . ' Date Read, Sworn to and Subscribed before me.
to me well known,
Disapprove, —w_ Date_
`� II Notary Public, State of Florida
( Signed)
Building Inspector ' / J My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member —_ Member
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.