318 NE 101 St (10)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby uinde for the approval of the detailed statement 01 me 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 progreu of the work.
, 19
Owner's Name and Address ........1�/� � . _ No.J4fi_ . Str /.0/%-f
Registered Registered Architect and /or Engineer 111:1, ...•• ::.1111,.,,.... - 1..111
Name and address of licensed contractor _..r
Location and legal description of lot to be built on:
Lot Block Subdivision.. _..._.. ._._.....
Street and Number where work is to be done..1.. /04 4�! 1_11 1._. 1 ... .
State work to be done and purpose of building (by floors) ti; l2/ )( i .e . P* ..... 4.._.._.._.._..._
STATE OF FLORIDA,
COUNTY OF DADE. I ss.
Disapproved ��.... {_J . Date
(Signed)
Building Inspector
New Bui!ding Remodeling Addition Repairs No. of Stories
To be constructed of ezwer2 /eXind of foundation 'sue �e Roof Covering
oe.
Estimate Total cost of improvements $ • ' Amount of Permit 5. ...l
and for no other purpose.
Zone cubage required .Plan Cubage
Distance •to next nearest building..... 0 )= r Size of Building Lot 7 .-j ?i6,
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.. 9/ / i - /®/ c...577.. /
l/ 3 l 2 -C*�
The undersigned applicant for this building perinit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5 Compiled General Laws of Florida, Permanent Sup c lement,
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 site of the work such public notice
or noticcs as are required by the Act. The undersigned agrees to employ only such su ntractors, - rk to be performed under this
pcnnit, as are licensed by Miami Shores Village. ...
Remarks (Sigt* ) e - e '
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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. gi6 Date .._._ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commiuion Expires _
to me well known,
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 Pl.rnnir.g Hoard.
A rc•impce•tion fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials anti /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of ire plans and specifications herewith submitted for the build •
inc 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 iivildinc 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 prs grew of the work.
,�/ Date. —_ _ ..._.... ,19. i.2—
Owner's Name and Address Fr' e ti! hl... _ No. t.4c/5 ...... stree A. ..oz. -S.Z
Registered Architect and /or Engineer ..... . ..•••...•.....+....•.•, *r
Name and address of licensed contractor .elui iii_.
Location and legal description of lot to be built on:
Lot Block Subdivision .... »._.__
Street and Number where work is to be done s... _. . . . —
State work to be done and purpose of building (by floors)..... t it r...Y' •?...e .0._t:. V. Z. k : :f :0:; .. � ._._
and for no other purpose.
New Building Remodeling Addition fi/ Repairi No. of Stories
To be constructed of Kind of foundation Roof Covering...( .it'2 VE_ 6. d kid _
Estimate Total cost of improvements $ O 0o. t► 0 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 poor
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 %sith 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks (Signed) _.._.. ...._._ .._:....._ _...
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re-inspection fce of 31.00 will be charged
materials anti /or workmanship.
Disapproved ........_...._ Date
(Signed)
Notary Public, State of Florida
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 ........ Date Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
Chair ;ran
Member
Member ... _.....- ...._..._._ ...._.......
Council Approved Date
PLANNING BOARD DATE
Member
Member
Member
Disapproved Date
making corrections or changes to this application niter approval has been obtained from
when such re- inspection is made necessary by Improper notice for inspection or faulty
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, whet rr 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:
Lot Block Subdlin
Street and Number where work is to be done 3 l `
State work to be done and purpose of building (by
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date..
nspector
PLAhI//// NINC BOARD
Chairman Member
Merhber Member
Member Member
Council Approved Date Disapproved
Disapproved
(Signed)
Building
rl 41 _ — No.. ...._....__. Street._
L.„1,e4A,',A,Ave
DATE
Date... !! _._....... ,19
My Commission Expires
Notary Public, State of Florida
and forno other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundatiop Roof Covering —
Estimated Total cost of improvements $ ~ r�.. , 6 ' ,(_
Zone cubage required
'� Amount of Permit $.
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 subc9 ors, on w•rk to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j Ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared —
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.. ..1_. ` � Date_. �� ._._ Read, Sworn to and Subscribed before me.
Date
has been obtained from
NOTE: A charge of $1.00 will be made for making corrections or changes to this application niter approval
the Planning Board.
A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspectirm or faulty
materials and /or workmanship.