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990 NE 100 St (14)c'4 s yr MIAMI SHEI ES /V ILAA[ E BUILDING INSPECTIO DEP TMENT APPLICATION FICO ING PE‘RMIT 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 WMER�_CONST_ INC. Location and legal description of lot to be built bjvision_ Street and Number where work is to be done f l State work to be done and purpose of building (by floors) STATE OF FLORIDA, COUNTY OF DADE. ss. Building Ins . ' or Chairman Member Member !� FEB 5 1969 r 1 / L 8©! / / ^Date ----- No. ?t9 }� 7C / l LANNING BOARD 0 (9 7 P rn_1 j /10/K 2 I - l / 33 /00 Sr. D/Z eit 19 ' - a n d for no other purpose. New Building Remodeling Addition / Repairs No. Stories.__ / To be constructed of C S - Kind of / foundation s7 Roof Covering ' C ']' Estimated Total cost of improvements $ / go Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot___ __? 0 -17- 13 ° 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 .neral Laws of F and has complied with the provisions thereof, and will require similar compliance from 'contractor in the work to be performed under this permit; and will post or cause to be posted for ' 'ection on or notices as are required by the Act. The undersigned agrees to employ only such su permit, as are licensed by Miami Shores Village. Remarks (Signed) orida, Pennanent Supplement, ntractors employed by him work such public notice be rformed under this 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 tru Permit No �d ` Date �( ( O! Read, Sworn to and Subscribed before me. Disapproved ( Signed) to me well known, Notary Public, State of Florida Commission Expires DATE 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. Owner's Name and Address .- j1 A State work to be done and purpose of building (by floors) be sent to MIAMI SHORES VILLAG E BUILDING INSPECTION DEPARTMENT APPLICATION FUR 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. Registered Architect and /or Engineer Name and address of licensed contractor _ -WATERS- :CQNST.__0,. INC. Location and legal description of lot to be built of Lot___'._..___ Block 1 1 (/ y ltdivision Street and Number where work is to be done FEB 5 1969 [M Date - -•-- - - -- - -- Frg j-� c � , / N / /tStrttet._ -. o 7 • /4 4c.e 1C0 { foil fa 14- /`ddvii Y17/COIWA S a -// 19 o and for no other purpose. New Building Remodeling Addition v Repairs No. o St ries To be constructed of___ -L__ S - Kind of foundation S T -� ° / Roof Covering , � Estimated Total cost of improvements $_____-- /. _g _ Q_L 0 Amount of Permit $ Zone cubage required _Plan Cubage // Distance to next nearest building ..Size of Buildilgg�Lot__1- Maximum live load to be borne by each floor hereby submit all the plans and specifications for said building. All notices with reference to ,the building and its construction may 33 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 .6eneiial Laves of Florida, Pennanent Sup plement, and has complied with the provisions thereof, and will require similar compliance from I contractoyor b,contractors employe by him in the work to be performed under this permit; and will post or cause to be posted fo specti.n on s' e . he work such public notice or notices as are required by the Act. The undersigned agrees to employ only such s � : c tor r o to be, erfonned 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 Date Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector My Commission Expires Notary Public, State of Florida 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 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.