802 NE 100 St (8)Application is hereby uinde for the approval of the detailed statement of the plans and specifications herewith submitted for the build -
ing or othe structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores \'ilLFgc, 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.
Date..._..._...m . S� _._..__._�_..._. ... _.. ,19..
Owner's Name and Address . ..Q J k � .. Street._N E ° /Go.
Registered Architect and /or Engineer 11 .......
Name and address of licensed contracto .. e4Z
'too St
Location and legal description of lot to be 4 ,I i1tt on: p �/
Lot 0 . 14/414,0. .... Block pp Subdivision ... & - !
Street and Number where work is to be done. C?,..... Nie /._ e_0....
St work to be one and pure .. a of building (by floors ). �. �Cttt - _1i?4 Y q
......��,4 �'..�°.� tea if►. /.�." ...C(li�s C
New Building Remodeling Additio s
Repair
To be constructed of Kind of foundation
Estimated Total cost of improvements $
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 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 i, tion on the site of the work suci ublic notice
or notices as are required by the Act. The undersigned agrees to employ only s su• antra • s, on work to be y •rm . . •er this
pennit, as are licensed by Miami Shores Village.
Remarks.___
Disapproved Date
(Signed)
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
. IiQI.><a.l
Ecc .. . —kr u.L F. -tne C-
/ 30 O OH#
Ores
k' (e W
..r and for no other purpose.
No. of Stories
Roof Covering
Amount of Permit $� ' 4 t
Plan Cubage
Size of Building Lot
La of F(,
igned)
Ft
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.._._... Date Re _C'�. worn to e
ary Public, Stat
My Commission Expires
PLANNING BOARD DATE
me.
of Florida
Notary, Public, tate - of Florida at Large
My t irarra Ch 19; 1
Bonded by ;owa'tiat`iona! Ins. Co.
Chairman Member ...... ....... :.._
\fcrnber 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 ):ward.
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.