339 NE 100 St (9)APPLICATION
Application is hereby made for-the approval of the plans and
specifications herewith submitted for the building or other
sturcture herein described. This application is made in com-
pliance and conformation with the Building Ordinance of the
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 Department of
Miami Shores Village, shall be complied with, whether specified
or not.
OWNER
ARCHITECT (4 J. �; ' 4 ``:� CONTRACTOR
LOT )7'r W t ` ' BLK y� /SUBDIVISION STRE ,/ / 6
NEW,, ADDITION REPAIRS NUMBER OF STORIES ROOF
COST (excluding Archtitect is fee, landscaping _ garage)„ y .v
Building to be used for =,;.. •.,u; .. and no other use.
I hereby submit 411 the plans and specifications for said building.
STATE OF FLORIDA) Signed
COUNTY OF DADE )
Before me, the undersigned authority, a notary public, duly
authorized to administer oaths and take acknowledgment, personally
appeared to me well known, and
who, being by me first duly sworn, upon oath deposes and says that
he is the builder of the above described construction, that he
has read the foregoing application, and that he did sign the same,
and that facts stated by him are true, Read, Sworn and Subscribed
before me,
My Commission expires
Cubic Feet /1(5' // Cubic feet required in this Block � 2 t
Chairman
Member i'
Membe
Secra - y
Building Inspector
Permit No. %) Issued to
Electrical Permit No
BUILDING 'PERMIT kACORD
MIAMI SHORES VILLAGE
FLORIDA
Notary Public(Signed)
.PLANNING BOt
Ai
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r lu'nbing Puri tt No.
DATE ` 1 0 • s 0
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Date