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1280 NE 102 St (9)APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement or me 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 STATE OF FLORIDA, COUNTY OF DADE. i ss' Permit No. Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Registered Architect and /or Engineer ,, ,,•••• •,,,•••, ,, •,t „t1TT!t,1,•, Name and address of licensed contractor ..(.v 5't^ /4 GFP.1/ P-.57 NGv Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done G !” 0 _ - - 2 S State work to be done and purpose of building (by floors) Ni <s .. ..... . F If,ARf _..� and for no other purpose. New Building Remodeling To be constructed of Kind of foundation Estimated Total cost of improvements $ Date Building Inspector Cod a Amount of Permit S. 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 th of labor under e Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup rleuient, 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this pcnnit, as are licensed by Miami Shores Village. / , Remarks . __._ . —_ ( Signed '\ Li lt' • - ✓�t4 .G 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. NOTE: A charge of $1.00 will be made for the Planning Board. A re- inspection fee of $1.00 will be charged materials and/or workmanship. Date Chairman Member Member .. ... _sass.- ...._. sass_ Council Approved Date PLANNING BOARD DATE / f .__sass._. .—....,19 Z No...l Z .K sass... Street e t1° Z....2 r . _. ..� pa ..._._._... ..._ ._....r ._ .. - . — R f Covering Read, Sworn to and Subscribed before me. Addition Repairs No. of Stories Notary Public, State of Florida My Commission Expires _.».........._ .— Member Member... Member Disapproved Date making corrections or changes to this application niter approval has been obtained from when such re- inspection is made necessary by improper notice for inspection or faulty 1)4E 0'4- P4 � v3 .J5 Pi._ S1/4At• ,.A 0 A•41,4 \, Ilkwaw G v 00'10 N 2x 4 Q T Q,s QT A T c- k q R^,c‘, a C■vwQ w 1 ' J4 " � R.b moo, c 4 R s t u.OT ?•... 'gut.) Re,s,oerrce of Ma k.S"1stS As -'opt 12'60 14.1.. % oZ S•r. M.wr«i S.e.elits,rt. %t■A■ treceW Fos.A.C.VMwr 4 tequila 0 eot, QR U.C.S. g • 2 -82 IS`'T • ell APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement or me plans and specifications herewith submitted for the build inc 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..._... !.. — .. --1..--..—.----.. ,19.F.L _ Owner's Name and Address . ( Q L. 4.T&&d _ No...._...» ....... Street._.. Registered Architect and /or Engineer nn. sn•......+em..1 EMIT! Name and address of licensed contractor 2.,4 . ,t. Location and legal description of lot to be built on: Lot Block Subdivi ;ipn c G f /a ai State work to be done and puprpose of budding (by floors) _.,.h..3 11 r hf�A!1.= _ S' S- �!?li_._.._.._.._ and for no other purpose. New Budding Remodtiling Addition Repairs No. of Stories To be constructed of Kind of foundation . Roof Covering _ _ lie Estimate Total cost of improvements $ o-O y Street and Number where work is to be done ... STATE OF FLORIDA, 1 . COUNTY OF DADE. j ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT 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 Supplement, and has complied .•ith 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. � 'k �/• 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 . Peit No 1 Date )0 ;114 > ...... Read, Sworn to and Subscribed before me. Disapproved Date — (Signed) Notary Public, State of Florida Building Inspector My Commission Expires __.._..._.._...� ._ ___. PLANNING BOARD DATE Chair :ran 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 Pl.rnnir,;.: Board. A re.in'.pection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship.