Loading...
825 NE 100 St (5)BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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 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 Addres Registered Architect and /or gineer.... Name and address of licensed contractor Location and legal description of lot to be built on: I hereby be sent to.... peared Building Inspector MIAMI SHORES VILLAGE Permit No._____ Disapproved Date (Signed) s and M ecificatio for building l not es Chairman Member Member Council Approved NOTE: A charge of $1.00 will be made for makin the Planning Board. A re- inspection fee of $1.00 will be charged when materials and /or workmanship. 6/ a#2thila N cpail Stree te4i - e Ogfr.,0/14, Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors)..: and for no other purpose. New Building Remodeling To be constructed of Kin. •f foundation Roof Covering Estimated Total cost of improvements f . f-, Amount of Permit $ Zone cubage required Flan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor Addition Repairs No. of Stories Member Member Member Date Disapproved g) corrections or changes to such re- inspection is made 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 )p1contra s, on k to bp7per ed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) 1 STATE OF FLORIDA, COUNTY OF DADE. J Before me, the undersigned authority, a notary public, duly authorized to administ i oaths and take acknowledgments, personally ap- 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. PLANNING BOARD DATE fere• /! • thq building and its construction may to me well known, Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires Date this application after approval has been obtained from necessary by improper notice for inspection or faulty MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT 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! ier herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. e • STATE OF FLORIDA, COUNTY OF DADE. J ss • Building Inspector Owner's Name and Addres Registered Architect and /or Figineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done � �. State work to be done and purpose of building (by floors)..' ! 4 r Permit No Date Disapproved Date (Signed) Remarks (Signed e / 0 .1• New Building Remodeling To be constructed of Kin Estimated Total cost of improvements t Amount of Permit $ Zone cubage required plan Cubage Distance to next nearest building. Size of Building Lot Nol Stree Read, Sworn to and Subscribed before me. ,r.. ,19 and for no other purpose. Addition Repairs No. of Stories of oundation Roof Covering d1 o Maximum live load to be borne by each floor I hereby pf ' all s andjpecifications� or said building.9,p11 notes wit h,referen'Fe'to . the building and its construction may sent to /� The undersigned applicant for this building pennit 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 ssu contractnrs, on ork to be per armed under this permit, as are licensed by Miami Shores Village. � � P_ . 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. Notary Public, State of Florida My Commission Expires PLANNINC 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. /,20' P1 ' 171 /20'