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970 NE 100 St (6)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 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 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 )70 19 ! Owner's Name and Address Y it • �O 6 W4 / No. ? 77c) Street � /00 Registered Architect and/or Engineer �� A1 / / Name and address of licensed contractor v i L 4/ 'mot/ ) • 44� Ai 4,6 "f / 01 2� (Ai , 2 J7 Location and legal description of lot to be built on: �' r ' • /� 4 ) ' " c)10/4. Lot j �ti Block S ubdivision /7 9 g.S� ' ff / /,�ao ,fy e,-,„, F NE , Street and Number where work is to be done / 7 , V E 70 Lr • State work to be done and purpose of building (by floors). state exterior colors (submit samples) Arc VA 6 /^/ 60,/ c 7;7e 7;7e 3 (il...," or 4,i/.6 7 f 7. 3300 s / f and for no other purpose. New Building Remodeling Addition Repairs No of Stories To be constructed of Kind of 3 foundation Roof Covering 7/(r / J r � 1—'4) $ Estimated Total cost of improvements $ //, , Amount of Permit 00 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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to Remarks (Signed) STATE OF FLORIDA COUNTY OF DADE. Permit No. Disapproved (Signed) }SS. Date /.334 9 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 pe 't: 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 e oy only such su• contractors. on work to be performed under this permit. as are licensed by Miami Shores Village. 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 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. Data:fill! � Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. Name and address of licensed contractor Disapproved 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, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Dew/the/La Owner's Name and Address CH. Gamed — No. .. . Street_–_. 970 N.& /00 StReet Registered Architect and/or Engineer Location and legal description of lot to be built on: Lot Block Subdivi ion Street and Number where work is to be done 7O N. /00 Simei State work to be done and purpose of building (by floors) Re-itoot 2o A of ale 400fins ce;717L, Date.. (Signed) Building Inspector y36-ags/ MIAMI SHORES VILLAGE A.B. Maittin Roo 3378 N.W. 53 Seet I PLANNING BOARD Chairman Member Member Council Approved Date and Subscribed and for no other purpose. New Building Remodeling Addition Repairs No. of Stories Roof Covering To be constructed of Kind of foundation cement A Estimated Total cost of improvements $ 948t00 Amount of Permit $4. 5.00 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 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 subcon ctors, on work to be performed ender this pennit, 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 to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is of the above described construction, that he has carefully read the foregoing app i cation, nd that he did sign:the same, and that all facts therein by him stated are true. 4 1 coc Permit No.. L Date Rea e . Notary Public, State of Floihia , — NOTARY VIM STATE O lORDA AT LAROP My Commis,ACPCONABINPNIXIMETSAFIriinfiF THRU GENERAL INSURANCE JNDERWRITERS DATE Member Member Member Disapproved Date has been obtained from NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval the Planning Board. A re fee of S1.00 will be charged when such re is made necessary by improper notice for inspection or faulty materials and/or workmanship. 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. Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor eerie 6% eX-12I 4 �^ Location and legal description of lot to be built on: Lot Block Street and Number where work is to be done State work to be done and purpose of building (by floors) Subdivision New Building Remodeling + To be constructed of Kind of found�1 Date - / ' ,19 S f Q(.t 0 No Street Addition and for no other purpose. Repairs No. of Stories Roof Covering Estimated Total cost of improvements $ 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 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 5968, 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. ction on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such suAp tractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ss. 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. CI' Permit No Co Date _ Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector Chairman Member Member Council Approved PLANNING BOARD DATE Notary Public, State of Florida My Commission Expires Member Member Member Date Disapproved Date NOTE: A charge of $1.00 will be made for making 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. corrections or changes to this application after approval has been obtained from Owner's Name and Address Lot. Block.. Street and Number where work is to be done MIAMI SHORES VILLAGE BUILDINho INSPECTION DEPARTMEN"' APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statemen! of the plans and specifications herewith submitted for the build- ing or oilier structure herein described. This ;ipt is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws cf the State; of 1•I rid::, all o'dinances of Mi Inn Shores Village and all rules and regulations of the Building Divi :,ion of \ii :_mi Short-7 \ illage sh -1 .;c , •ompl.ed with, whether herein specified or not. A copy of approved plans and specifications must be kepv at building durin progress of the wcrk. Registered Architect and /or Engineer_. Name and address of licen•,ed contractor i__ ..___. �_. __• _ _ _ Location and legal description of lot to be built on: Subdivision__ Date No Street State work t e do 4 ne a d }� 1 purpose of building (by floors)_________ ="x : r New Building_ ________ _ _ _ Remodeling_ Addition__ _ _ __ ___ _____ ____ Repairs. _ and for no other purpose. No. of Stories To be constructed of __ . _. _ _ __ Kind o f __._ _ . Roof Covering._ Estimated '7 AO cost of improvements $.. (/ U . p Amount o` Permit $.. _ . Zone cubage required __. __Plan Cubage Distance to net nearest building.. _Size of Building Lot Maximum live load to be borne by each floor . hereby submit all the plans and speciiic•ations for said building. All notices with reference to the building and its construction may be sent to The unde signed appli ant for this building permit does hereby certify i■at he understands and accepts his obligations as an employer of I:•bor under he Florida Workmen's Compensation Act bong S (lion :59613, Co;t:piled Gen - Laws of Florida, P. r,! anon Supph vent, and h s compl ed w•:th he provisions thereof, and will require similar coma iarcce from all contractors or subcontractors cmplo •ed by hint in the wo k to be p ri 'med under this pern it • and -vill post or caus,: to be pester) for inspection on the site of the work su.:h public note e or '.otices as are regwr• d by the Act. The u: el, r•ign;•d agrees to employ only such rubcontr. ctor on work to be perforn, d .• der this permit as are hcensed by M am: Shores \ Remarks. - - - - -- -- - -- - - -- (Si;oed) PLANNING BOARD DATE Chairman ._.___ _. __. _ ________ ___ Member Member . ... .. . ... .... ... . .... Member Member _ Member Council Approved _ _ . .Date Disapproved 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 to me wel! known, and who, being by me first d ly sworn, upon oath deposes and says that he is the of th abov. de L lied istruction t, : h has careially read the foregoing application, and that he did sign the same, and that all facts therein by him stated are tr,ie. Permit No Date ._. Read, Sworn to and Subscribed before me. Disapproved Date___ _ Notary Public State of Florida (Signed) — - -- - - Building Inspector My Commission Expires. Date NOTE: A charge of $1.00 will be made for snaking corrections or _hanges to this application .:ft.•r approval l: -s b.. a flit am ed from the Plamrng Board. A re- inspection fee of $1.00 will be charged when such re- inspection is mi: to necessary by improper notice fc r imps tot' or fat ty materials and /or workmanship. 0 CA Cry rvz 5 R/ 1 LI enenl4nA 0-1-ta col c wS.