38 NE 102 St (10)MIAMI S
BUILDING IN 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 Addres%
Registered Architect and /or Engineer
Maximum live load to be borne by each floor
ss.
NOTE: A charge of $1.
the Planning hoard.
A re-inspection fee of S1
U. /' /S Al
Building Inspector
' jap_ees
Name and address of licensed contractor
New Building Remodeling Addition X
RES VILLAGE
To be constructed of Kind of foundation
Estimated Total cost of improvements $ 5 O v amount of Permit $
Zone cubage required plan Cubage
I hereby submit all the plans and specifications for said building. All notices with
be sent to N. b L 4 Ad 4.2„ SD 0 yY 2- S. E'. D 1
Disapproved Date
(Signed)
Chairman
\fcrhbcr
Member .......
Council Approved
�.�._ . _ No. ...3..? street.A1. . ® S
Location and legal description of lot to be built on: n
Lot 7 ._� '� 9 Block 1) Subdivision /01./.4,..,„0" I . .. - � 1.. .A. ..cs _ - S c GT
S and Number where work is to be done AV 4 _ � ST -- ^ -- - -
State work to be done and purpose of building (by floors) . te. _ "' � 7-;P
and for no other purpose.
Distance to next nearest building "` Size of Building Lot
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 hint
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.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
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 �j
Permit No.._.__il.I Dat
�- Z " _.� Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
Member
Member
Member
/7/6f
Repairs No. of Stories
eferenc to the building and its construction may
7 yang
to me well known,
Notary Public, State of Florida
My Commission Expires
Date Disapproved Date
has been obtained from
00 will be made for making corrections or changes to this application after approval
.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faul /
materials anti /or workmanship.
MIAMI SHORES VILLAGE
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 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
Disapproved
(Signed)
Date..
Building Inspector
Date w ~ - — ..s ,19
. .. ' ..L
&" .._ — No......_.. Street_.. ./ 5 ''`--.
State w - o be done and purpose of building (by floors)
/�/•4?-1.-ft G /L -G;-. `,4cz__
rf p
Location and legal description of lot to be built on:
Lot 7/ 2 / Block 1/ Subdivision
s
Street and Number where work is to be done 3 8 r) ' -•`•�� ��••
Remarks (Signed )a
NINC BOARD
Z t'
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 $ � _ t — -- --
Amount of Permit Se
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 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 subcop ors, on work to be % ed under this
permit, as are licensed by Miami Shores Village.
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
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 s ed art-4n".
/e>
Permit No. Date ,l_ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
DATE
to me well known,
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.
c,