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133 NE 100 StRegistered Architect and/or Engineer Name and address of licensed contractor elL^v M Location and le al description of lot to be built on: Lot Ji) Block Street and Number where work is to be done STATE OF FLORIDA COUNTY OF DADE. } SS. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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. Date 12 19 Owner's Name and Address o t' q 1 11 ‘ sQN a No. V gc,4•1 Street i 20J.V■ovl" N4tN$ 6-- / New Building Remodeling Addition Remarks (Signed) Date Date GRAN Nu (-2 5r 4. N w 37 Av.4 Subdivision '/ �e b ge .1l RIO 11 3A 0 I /3 ozosJ \S4w cze- NJOW4 go- State work to be done and purpose of building (by floors), state exterior colors (submit samples) and for no other purpose. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligators 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 u 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 grees to mploo onlych subco..ra.y.•rs. on work to be performed under this permit, as are licensed by Miami Shores Village. To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements S 2 1 Amount of Permit S 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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to Repairs No. of Stories effa 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 fpregoing application, and that he did sign the same, and that all facts therein by him stated are true. Read. Sworn to and Subscribed before me. Notary Public, State of Florida Before me, the undersigned authority, a notary public. duly authorized to administer oaths and take acknowledgments, personally appeared to me well known. Permit No. Disapproved (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. Maximum live load to be borne by each floor Disapproved Date (Signed) :�.. Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal of the detailed statc.,,inr ur inc 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 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. ate......__. 4 Owner's c�a. id Address LlO 2 r.,2�(::t.;:. ...1L.S�'�..i. ._._ No...../...1.3. . Street l.`d • _1. .ra 614, kN6tt, VtpY �r�7 � Registered A rchitect a d/ r^ rig .cer.......... — � — ` 'Q.l.c.1C.'�J..°4..... ?t,,..U..4,t e,',,, /,�4.�/„lrrl. q lre55 Name and address of licensed contract° i1Q.1.I.LJ . Ql. T °l,_ -SS ; _ , sok) ._ kei • _2 Location and legal description of lot to be built on: 'T(p 4 554- I (Y1 e 19. -5-3 l Lt Lot Block / G 1�. Street and Number where work is to be done..._......... /. 63.. z _ .i rr..._._ a .. -- .._ ,,.�.�,,�� State work,to done and ,purpose o buildin by floors)....._DID .d.) .Cis/ . ig!(. ±...i. 1 .177- - - . to .�n.�r .. .... .... . ... r ..r e . I CL 1,04.1/.1 � . .ln. . ..warn. — DN2V Cn �. _ >n � c... r Iic.. -- c i — a.irA .e....._.. - .....l s ` ' _ ..... . ... _. .� 1. _ .. �+�ri H'Y° o other purpose. New BuNdrns Rcmodcling X Addition epairs $.14 ! No. of Stories sass To be constructed of . ,.(. °...le..... Kind of foundation ( .... .(,1�,11C.:S:.t1,.d.t 4 .t.Q Roof Covering..Q... Lt.. Ere - Estimated Total cost of improvements $. p d.°e on r .j i) Amount 'of Permit S.. Zone cubage required g. All tees with refere o the bui ing its construction may Ian Cubage Distance .to next nearest building. .... Subdivision .. I hereby submit all the plans and s eci icjitions for said di be sent to.. (� .......... ..1.'50 . �t r .. /.. aul!v4. ..... ( . - . ) .... 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 \Vorkinen'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 a ploycd 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 s ch public notice h or notices as are required by the Act. The undersigned agrees to employ only such •n• actors, on worls. be performed- u der this permit, as t are licensed by M • Shores Village. (^ Reinarks. bea-.ut1.... -. .. - IL _ r0 D (Si STATE OF FLORIDA, 1 . ' bon iAl COUNTY OF DADE. j s Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap - peared ,� DD 4a.. .e_Ct ,,]� �.�1/. ize of Building Lot 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.. _ Z q Permit No.. h Date '1 !. .... sas s._._ Read, Sworn to and Subscribed before me. _sass Notary Public, State of Florida to me well known, My Commission Expires _ ....._..._.._ . .w. 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. Chairman Member Member BUILDING INSPECTION DEPARTMENT 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. STATE OF FLORIDA, COUNTY OF DADE. j ss. MIAMI SHORES VILLAGE Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on Lot Block Subdivision.. No Street Date ° ^ 2 5 19 ° Street and Number where work is to be done ._1._3__1 '7 ' G State work to be done and purpose of building (by floors) 0 - - i - 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 subcontrjct�s, on w81=jc to be performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed) _. Notary Public, State of Florida PLANNING BOARD DATE Before me, the undersigned authority, a notary public, duly authorized to administer oaths and tak ;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 (Signed) Building Inspector My Commission Expires 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.