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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.