Loading...
164 NE 100 StOwner's Name and Address______ Mrs� Uhatfield Registered Architect and /or Engineer 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 regula- tions 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___Ilara_- 19A$_ Name and address of licensed contractor Little Jobbers, _2201 .1a W��tb✓AQe Location and legal description of lot to be built on: Lot_----------- - -__ –_ _ Block Subdivision__–__–____—_____ _______________—______________ Street and Number where work is to be done 231_ N, _ E, 971 i _ St._ work to be done and purpose of building (by floors)____ Re _it.d54r_13_,__I- @P?ai2'___fltOTegnny vVindo _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 $_ 54_00 _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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. se. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that be has carefully ° d the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ���� l' Permit No c / GJ T Date_ Read, Sworn to and Subscribed before me. - --------- -------- -- Date Disapproved Notary Public, State of Florida (Signed) Chairman Member Member Council Approved___— ______________ Building Inspector My Commission Expires__________________ PLANNING BOARD_ _DATE Member Member Member __Date Disapproved Street_ N1__E...___LQ0it . t • to me well known. _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.