270 NE 101 St (8)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.
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:
rs, Lot— ' — __�______ Block_r ___ Subdivision e �
Street and Number where work is to be done \ J . F (\ V "
New Building ________________________ Remodeling____ _____ Addition
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
Disapproved _____— — _ —W —___ Date
(Signed) ----------------------------------
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
1 0_1 1 1 \ \, i�,;
,t
_Plan Cubage
Size of Building Lot
1 ' -- - - - - -- 19
NO. _ -Z eJ Street _e _° _ _
State work to be done and purpose of building (by floors) ?�`� �� , ..
__and for no other purpose.
Repairs No. of Stories____________
To be constructed of_____ ______ Kind ,of foundation Roof Covering_
Estimated Total cost of improvements _$ ��� _Amount of Permit $ 0
Zone cubage required
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 be 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 a ct c ,subcontractors, on work to be performed under, this
STATE OF FLORIDA, //.. :i - I'. ✓ %) ,
COUNTY OF DADE.
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 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 _L_
� ° // - ? / _—__ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved
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.
MIAMI SHORES VILLAGE
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 work.
Owner's Name and Address
Lot — n*
STATE OF FLORIDA,
COUNTY OF DADE.
Permit No
.0 •
Disapproved _________________ Date_
BUILDING INSPECTION DEPARTMENT
Registered Architect and /or Engineer
—
Name and address of licensed contractor
Location and legal description of lot to be built on: 4'
Subdivision I_ • • s a
Street and Number where work is to be done fi ° s
State work to be done and purpose of building (by floors) � ° �% N ��
:_ t' •.
_and for no other purpose.
New Building - -__ ___ Remodeling Addition Repairs No. of Stories__
be constructed of___________________ Kind of foundation Roof Covering_ —_ —�
Estimated Total cost of improvements of Permit $ --------
,1' __ _ __ _____— ____—_— ______—__ —_ —_—
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)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and 'take acknowledgments, personally
appeared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that be 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.
Date Read, Sworn to and Subscribed before me.
(Signed)
Building Inspector My Commission Expires
Street— .
Notary Public, State of Florida
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.