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302 NE 100 St (10)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 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. Q Date , 19ai .E Owner's Name and Address ( � EO /ts /e A/' 6/€ � �-L No ��_� Street___�._...��� Registered Architect and /o nginee . 6 Ala P N ER Name and address of licensed contractor._ e4 lee Location and 1 gal description of lot to be built on: .. 7 Lot / > Block '/ Subdivision 0 0 1 ' Shores- y /'�°+.�� .. Seal; o Street and Number where work is to be done ,30 2 Al E /&d a '�/ ' State work to be done and purpose of building (by floors). 19.71 A 0I-- Sfri u Tr - g 1 e_s TO New Building A Remodeling. Addition To be constructed of_.l"1 ET 4t Kind of foundation Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot .50 / x /15 C (/ 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. ,, ©� e Remarks ( Signed) A� %�' " � STATE OF FLORIDA, F COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ss. Date_ Date 4- Z 4/ and for no other purpose. Repairs No. of /T Storries �� Roof Covering n L4444 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 Disapproved !�_C= (Signed) L` Read, Sworn to and Subscribed before me. Notary Public, State of Florida .00 sox) Alm/A1 v f; Building Inspec My Commission Expires LANNING BOARD DATE Chainnan 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. u APPLICATION FOR BUILDING PERMIT (\ -s'. 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 $I1ores Village, Flai'ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the .wilding 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._ i' _ .141Dis* nceeptaext Maximum live loa X I sub be sent to Owner's Name and Address Registered Architect and /or ngine Name and address of licensed contractor.. 5 /e-41i9'.,42 ev 00 r) A) Location and 1 gal description of lot to be built on: f_ - Lot 47/ / 2 ' Block 1 Subdivision / %/� • 5boreS — Seel, / e / Street and Number where work is to be done 30 2 - ) State work to be done and purpose of building (by floors) NTT' © � D PC)4()AJ SOUTT ieS T o >(/S r%N67 ,e / . and for no other purpose. New Building Remodeling. Addition )( Repairs No. of Stories To be constructed of_ . 1= 7/41 Kind of foundation Roof Covering A Estimated Total cost of improvements 4o Amount of Permit $ ion cuba rrequ A plan ssuilding._ be borne by eac life plans and The undersigned applicant for this of labor under the Florida Workmen's and has complied with the provisions t in the work to be performed under thi or notices as are required by the Act. permit, as are licensed by Miami Shor Remarks STATE OF FLORIDA, COUNTY OF DADE. ss• Before me, the undersigned authority, peared Date. Building Inspecto MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT e st) CA , j976 AJ& .2 S S ations said a ai. �"` - -2 ( i'4 Date ecif . ui . Co le p 1 e Vi a notary public, duly authorized to administer oaths and !No 3a 2. Street. -Ng- 10Q a 'x /15' e rye') 467" (200 / /S rence to the building and its construction may g permit does hereby c tands and accepts his obligations as an employer ensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, , and will require similar compliance from all contractors or sub - contractors employed by him it; and will post or cause to be posted for inspection on the site of the work such public notice dersigned agrees to employ only such subcontractors, on work to be performed under this age. (Signed) il%ty1. Vt /4 01'L A t' Al py oC, take acknowledgments, personally ap- 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 j.-6 -�i Date 4- - Z7 ( Read, Sworn to and Subscribed before me. Disapproved (Signed) Notary Public, State of Florida My Commission Expires ANNING BOARD DATE Chainnan 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. • '