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237 NE 102 St (12)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date e' - .S 9tf. Job Address Z 3 7 W. /02 Si: Tax Folio /1 - .�2 O( 0/3 - "T 9g) Legal Description Sec . t 3 L*' 15 + «' Historically Designated: Yes Owner/Lessee / Tenant /`lk . CIA b v� �+E 4- LL 1 s o Owner's Address 23 7 Ill. , , / O 2- sr-. M / Phone 75 / (p Contracting Co. /t/A Address Qualifier It//4- SS# Phone State # Municipal # Competency # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN it , Square Ft. Estimated Cost (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. .4_ ..i/ :. 11 Ai Signature of owner and/or one o President Date Signature of Contractor or Owner- Builder Date SHEILA} m ' 5/qco Notary as to Owr16 . ,• or Condo President Dat Notary as to Contractor or Owner - Builder Date My Colrunission Expires: 1 O / My Commission Expires: OFFICIAL NOTARY SEAL SHEILA MULLER NOTARY PUBLIC STATE OF FLORIDA ` COMMISSION NO. CC501457 MY COMMISSION EXP. OCT. 12,1999 Address Address FEES: PERMIT I" RADON C.C.F. ' NOTARY Master Permit # Ins. Co. s^— No -� 4 iO 37€/ BOND TOTAL DUE '1 APPROVED: d Zoning Building Electrical Mechanical Plumbing Engineering Owner's Name and Address . a•A - STATE OF FLORIDA, 1 COUNTY OF DADE. ss' Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby n for the approval of the detailed statement or the plans and specifications herewith submitted for the build • ine 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. — . .�No � ,� Street 2.... 3-7 . Registered Architect and/or Engineer.. = _ /c2 n,•,..,,.n<.,....•,,....., .. Name and address of licensed contractor./4L -t- 1 2 0 04.1 M =. U.. Location and legal description of lot to be built o / ? / Lot. /�Z. /6Ntl..1 Block 3 r Subdivision $ l 4 .i_�_ �1. � !.1 f �J .._ Street and Number where work is to be done...-- l ... State work to be done and purpose of building (by floors) New Building Remodeling � Addition Repairs To be constructed of Kind of foundation ( Roof Covering c d , Estimated Total cost of improvements $ l� .1. .... Amount of Permit & ` 5G, ' tr) Zone cubage required .Plan Cubage Distance .to next ne.irest 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 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. (�� , Q Remuks (Signed -) ` ,( t!�,!� 5 A_;- Building Inspector /SD /1 geared and for no other purpose. No. of Stories / Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- to me well knosyn, 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.. k' Date.... ,1 d' Read, Sworn to and Subscribed before me. Notary Public, State of Florida MyCommission Expires _ _........._ _ ..� _.�. PLANNING BOARD DATE Citair:nan Mcmbcr Mfcrr,bcr Member _ Member .. .. _.....__....._..._._ ...._....... Member Council Approved Date Disapproved Date NOTE: A ch.rrge of $1.00 will be made for making corrections or changes to this application after approval has been obtained frrnn the Plannir.;; Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty materials anci /or workinanship. 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 he kept at building during progress of the work. Date Owner's Name and Address / ", "` •I G `- !c f.: No. -), '; ^ Street / 4 ' -' R.egistered Architect and /or Engineer t ` .:.c._ < - % ./ - A:-', t- %' 1 Name and address of licensed contractor ".7 /_t .;__. ,Z r'./ .i ( ,f ,,' { • ' •' _-• • . i ji ' .. 't.p,. /,c' L3 ,... Location and legal description of lot to be built on: Lot ` _ 7 Block -''�- - Subdivision. - Z -� l ; :c,•i / - /?T �' 7 r � -�,�I ,_ , , 3= a Street and Number where work is to be done / '' 6 ?. J State work to be done and purpose of building (by floors) i ; /;s'' "'x1 ``r'` /A' {' Building Inspector PLANNING BOARD_. ,; and for no other purpose. New Building Remodeling Addition Repairs No. of Stories / To be constructed of ' - Kind of foundation Roof Covering - ----- Estimated Total cost of improvements $ 1' / r:• G 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._ fu R / • ' • -. - /. 4 _ .c. c, • - - r ly -- CI !1- L t , /72 , /�' /t - J !,';!C c , C r 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 subcontractors, on worl5 to }se performed under this permit, as are licensed by Miami Shores Village. , (i� ( Remarks l '� E .1_c cam_, - - - ( Si gne d ) -- --- 4:(, . ._1a :_,.r,,, j STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly auth ized to administer oaths and take acknowledgments, personally ap- peared yv r "[. /9 -/►.� U7 • t I 050/ 5 ,J 0 4). I- ' Si /J 1344/ °' /4 4 )/Ge 6 Q / to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. i A-G( / /AIGl f 647.w.„7 of the above described construction, that he has carefully read the foregoing application, and that he did sign the same; a tha't therein by him stated are true. _ ti Permit No Date....- Read, Swo 1 io an Subscribed b fore i�z.:' d Disapproved _.. Date _ -- - _• - -- ' -- 1 d � ' (Signed) tate of on a ,. .,* ;� e My Commissio TARK, PUBLIC:, sTATE)OF a RIDA ,Ar LARGi3 BONDED TICRU FI ° Y . DQE CInST .° DATE ' ,.` Chairman Member M cmber 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 heen obtained from the Planning Board. A re- inspection fee of $1.1)1) will be charged when 511(11 re- inspection is made necessary by improper notice for im,pectinn or faulty materials and /or workmanship. 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. �-- Date_ - O — / 5 — Owner's — s Name and Address 2 - /2 4 (L� � -!� !V _______ Nod 37 "1 Street_ / 0 2 Registered �- t �cJO Street and Number where work is to be done STATE OF FLORIDA, COUNTY OF DADE. j ss Disapproved ) MIAMI SHORES VILLAGE APPLICATION FOR pUILDING PERMIT wilding Inspector BUILDING INSPECTION DEPARTMENT Architect and /or Engineer _ 4.4) Name and address of licensed contractor_ 4 J 4 ' Location and legal de ption of lot fo be built on: Lot( 1 -_ _- Block 3l0 O.VO DEci,QG Subdivision State work to be done and purpose of building (by floors)._ Lie- 46n° oors )____ /_J_e- 46n° ��► ( Signed )X (...L.4 A- C. C e t ,19 rQ 5.S o r � T - D 4777f and for no other purpose. New Building Remodeling Addition Repairs No. of Stories , / To be constructed of Kind of foundation Roof Estimated Total cost of improvements $ l /0 0 Amount of Permit $ A 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 su mit all lans and specifications f said building. All notices with refere ce to the building and l itt construction may be sent to__ Ali_____ do Dee /l)G— I ,a .0. 40 it . Gtr. i�ateid 44 -°/D. 1 The undersigned applicant for this building permit does hereby certify that he understands and accepts his o bligations 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 subcontractors, on world to performed under this permit, as are licensed by Miami Shores Village. Remarks Before me, the undersigned authority a notary public, duly authorized to administer baths and take acknowledgments, personally ap- peared 515.0_-__10 . te a to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the V ALA Pro/ 6 46 of the above described construction, that he has arefully read the foregoing application, and that he did sign the same, andl that all facts therein by him stated ar true Permit No.__.__! v T Read, Sworn to and Subsc 'bed l foie me r ix)RED THRD FRED W. DIESTELHOR$T Notary Pu.lic, State of Florida _ _ ".?• s idiD1BR)6it1OBUC,- -STATE - 0F4EORI3A- -pfi = -L 6$ MY, COMMISSION EXPIRES OCT 22 1973 PLANNIN BOARD 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty - materials and /or workmanship. 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. / ' (�f� Date + 2 / 7 v Q j Owner's Name and Address.... >/-AW 3 .__ No. I Stre t__1_Y � L8 2 .19.. Registered Architect and /or Engineer Name and address of licensed contractor Location and // legal description of lot to be uilt on: l!, '� Lot_.lc.!'l(G!._.(. Block. IQ Subdivisi L�IJ� -�.A' Street and Number where work is to be done 2 3 7 N._ ,l__Q State work to be done and purpose of building (by floors) _____!� BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Building Inspe or 1 � MIAMI SHORES VILLAGE and for no other purpose. New Building Remodeling. Addition Repairs No. of Stories To be constructed of Kind �^ 6 off / foundation Roof Covering Estimated Total cost of improvements $_/_ 0 Amount of Permit $ Zone cubage required _'Ian 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 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 inspectio sit of the workch public notice or notices as are required by the Act. The undersigned such to be pe med under this permit, as are licensed by Miami Shores Village. Remarks 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, i and who, being by me first duly sworn, upon oath deposes and says tha he is the_ of the above described construction, that he has carefully read the for •oing application, and that he did sign the same, and that all facts therein by him stated are Permit No Date 1 -Z ' ° "' . Read, Sworn to and Subscribed before me. Disapproved ( Signed) Notary Public, State of Florida My Commission Expires LANNING 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. Owner of Building_ Architect Contracto or Builder Legal Descriptic Address Building MIAMI SHORES VILLAGE. FLORIDA BUILDING ELECTRICAL ❑ r PLUM BING PERMIT N9 81 U lr s ROOFING ❑ License No +' Work to be performed under this Permit ( This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the or ances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in th statement'or specifications and that he assum responsibility for work done by his agents, servants or employees. CONTRACTOR OR BUILDER Signed. BY AUTHORITY 1 B INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder is' compliance with all ordinances and regulation pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted tithe proper authorities of Miami Shores Village. In accepting this permit ssume res onsib,Uty for all work done by either, my e, f agent, servant or /mployee. 17 /1 / 6-- A C.. k— ) r f 1 ,A l n Lot Bl Subdi- vision f _ > i � i „. /� Sq. Ft Amt. of Permit $ � f . "... -. Value of 1 �, r ;t Owner of Building_ Architect Contracto or Builder Legal Descriptic Address Building MIAMI SHORES VILLAGE. FLORIDA BUILDING ELECTRICAL ❑ r PLUM BING PERMIT N9 81 U lr s ROOFING ❑ License No +' Work to be performed under this Permit ( This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the or ances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in th statement'or specifications and that he assum responsibility for work done by his agents, servants or employees. CONTRACTOR OR BUILDER Signed. BY AUTHORITY 1 B INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder is' compliance with all ordinances and regulation pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted tithe proper authorities of Miami Shores Village. In accepting this permit ssume res onsib,Uty for all work done by either, my e, f agent, servant or /mployee. 17 Owner's Name and Address...__. .iefrg"' Registered Architect and /or Engineer Name and address of licensed contractor Building Inspect .r 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. Location and legal description of lot to be built on: Lot Block Sub vision. Street and Number where work is to be done 3 State work to ate done anp of ding (by fl PLANNING BOARD Date P / � No Street ez a and for no other purpose. New Building Remodeling. Addition To be constructed of Kind foundation. Roof Coming Estimated Total cost of improvements $. , e n . © e ms Zone cubage required Repairs No. of Stories Amount of Permit $ 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 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 subcontractors, on work to . performed under this permit, 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 sayd'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 stet true. 9. Permit No.__.___ __.. Date_ ' 7 S Read, Sworn to and Subscribed before me. Disapproved (Sig Notary Public, State of Florida My Commission Expires DATE Chairman Member Member Member Member .. Member Council Approved D. - Disapproved Date NOTE: A charge of $1.00 will be made for making Corr: tions 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 e- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Form 130. CITY OF MIAMI FLORIDA OFFICE OF BUILDING INSPECTOR APPLICATION FOR BUILDING PERMIT (A copy of this Application, together with one copy of plans and specifications, must be kept at building during progress of the work) 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 con- formity with the Building Ordinance of the City of Miami, Florida which said Ordinance was approved July 7th, 1919. All provisions of the Laws of the State of Florida, all ordinances of the City of Miami, and all rules and regulations of the Building Department of the City of Miami, shall be complied with, whether herein speci- fied or not. ciAt Owner's Name and Address Architect Name and address of contractor or builder Location and legal description of lot to be built on: Lot /t7 9 3 o Block Date Street Subdivision Street and Number where work is to be done a 1 M Purpose of building (by floors) J I G�OI New Building Estimated cost of Improvements (not including fur Type of Construction Roof coverin Foundation Number of persons to be accommodated (maximum) per floor Size of building lot `S4 ' ! / street) • Heating system, if any (kind) (yes or no) Elevators: passenger freight a • and for no other purpose. g Addition pO Repair Number of Stories - ✓ ishings) $ 5 0 S Notary Public. My Commission Expires This space represents the lot; make outline of ground plan showing distance of building from all lot lines. THIS IS TO BE FILLED IN BY BUILDING INSPECTOR Footing Distance from next nearest adjoining building (from all sides except �'✓`�� Plumbing (yes or no) Elec (yes or no) manufacturer Maximum live load to be borne by each floor I hereby submit all the plans and specifications fo aid building.. I notice wi reference to the build- ing and its construction may be sent to (Signed) di,9 's , -'' r STATE OF FLORIDA, COUNTY OF DADE. SS. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac- knowledgments, 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 constructiion, 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. Read, sworn to and subscribed before me, .- r Permit No. % ` ^ ' issued upon above Application Classification Disapproved , 192 Reasons• (Signed) 19 No P. S1 CITY OF MIAMI FLORIDA (Little River District) (A copy of this Application, together with one copy of plans and specifications, must be kept at building during progress of the work) Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub- mitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of the City of Miami, Florida, which said Ordinance was approved July 7th, 1919. All provisions of the Laws of the State of Florida, all ordinances of the City of Miami, and all rules and regulations of the Building Department of the City of Miami, shall be complied with, whether herein specified or not. , 192 e Date Owner's Name and Address Street - No Architect • Name and address of contractor or builder Arlia W iraC1-4-1 Location and legal description of lot to be built on: Lot Block � ubvxsxon �C.+ I-'�'""' Street and Number where work is to be crone /0 A, M , 't • w Purpose of building ,. f New Building Remodeling Number of Stories /� / Estimated cost of Improvements ot,i lulling furnishings) $ 7 '50 D XL.. Type of Construction / Roof covering Foundation Number of persons to be accommodated (maximum) per floor Size of building lot %6X / Q 7 Distance from next nearest adjoining building (from all sides except street) Heating system, if any (kind) Plumbing Elec Elevators: passenger freight Manufacturer Maximum live load to be borne by each floor OFFICE OF BUILDING INSPECTOR APPLICATION FOR BUILDING PERMIT (Signed) Addition Repair and for no other purpose. 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 STATE OF FLORIDA, I S S. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowl- edgments, 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 building, 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. Read, sworn to and subscribed before me, t� (Signed) Notary Public. My commission expires THIS TO BE FILLED IN BY BUILDING INSPECTOR Permit No. / 61 c, v issued upon above Application , 192_ Classification Disapproved 192 Reasons: In this space give lot dimensions; make sketch of ground plan, and distance of building from all lot lines. - f.. 0 9 • (Si 1 1VAL Building Inspector. •