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94 NE 100 St (12)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, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. • L Z Date : T )C / .. _ , 19 i= Wnth Name and Addfess, :...G. u'1%Lf �ti No, �t E /UG Iva ,5 Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot. ¢- 3 Block r Subdivision 0 ch3L(15 Cedl /fw► Street and Number where work is to be done.. 9 _. 4. 1 / 00 S • State work to be done and purpose of building (by floors) _ /nif�/f t (? (o O New Building Remodeling Addition Repairs Repairs of Stories To be constructed of K' of foundagn \ Roof Covering Estimated Total cost of improvements $ 7 3 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 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 Flo ' en nent S plement, and has complied with the provisions thereof, and will require similar compliance from all ntractors or contractor empl ed by Dim in the work to be performed under this permit; and will post or cause to be posted for in ec ion the of the war such ublic 6tice or notices as are required by the Act. The undersigned agrees to employ only such sub tr Mo s, wo o—b performs! er this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss. Disapproved ( Signed) Building spector 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 thoregoing application, and that he did sign the same, and that all facts therein by him s ted are true. Permit No._____ ____/ Date Read, Sworn to and Subscribed before me. Date L.G. Chairman Member Member Member Member Member 0 \ and for no other purpose. Notary Public, State of Florida Commission Expires • PLA ING BOARD DATE c. - /-"e i L ' , (Lf -- 35/(6 - e6 1 to me well known, 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. Owner's Name and Address STATE OF FLORIDA, COUNTY OF DADE. j ss Building lnspcctor l ! 1 MIAMI SHORES VI LADE BUILDING INSPECTION DEPARTMENT. APPLICATION FOR BUILDING PERMIT Application is hereby wade 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 a d all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A/opy of approved plans and specifications must be kept at building during progress of the work. No.. .,f�. ° j 7 Dace..._..._....._... _— — -- ..— 2 i . ... , Ifl? Street_.._. / =1 - Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be bty�t on: Lot /—g 3 Z 455 35Block Street and Number where work is to be done 7 / State work to be done and purpose of building (by floors) i4.!.Y / A - -••.•- 2 L' / 0.3 A rT, t.... .1t11-1,1tttfttlIt..,ttlIrttIttftlE...1 111/4;;;/ S,eVc�.l' 5 e7; Subdivision �/.. l sT, and for no other purpose. New Building Rer od rag MIA x' Repairs No. of Stories To be constructed of NCO 4 I � d of foundation I ®uk � VCR 7 t_ t • •f Covering Estimated Total cost of improvements $ use 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 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 Su element, 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 subcontra s, 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 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 7 73 .._ Date Read, Sworn to and Subscribed before me. — , i�•_ , / Date - - -... r Notary Public, State of Florida Disapproved My Commission Expires 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 hern 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 et faulty materials and /or workmanship.