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429 NE 102 St (4)Form 130. Architect Name and address of contractor or builder CITY OF MIAMI FLORIDA Notary Public. My Commission Expires This space represents the lot; make outline of ground plan showing distance of building from all lot lines. 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. ti Date ' 19 Owner's Name and Address 1 � g ✓ �1��� " -�'• "' Street 4 Location and legal description of lot to be built on: /"' Lot I , .. Block V G Subdivision (,„ '' C ' Street and Number where work is to be done , ? z - - �' �, ` Purpose of building (by floors) (Signed) V ,Z ; aJa. and for no other purpose. New Building Addition Repair Remodeling Number of Stories ' Estimated cost of Improvements (not including furnishings) $ Type of Construction Roof covering el�� � �_� ^ �� Foundation 1: ' Footing Number of persons to be accommodated (maximum) per floor Size of building lot 7 `L Distance from next nearest adjoining building (from all sides except street) Heating system, if any (kind) (yes or no) Plumbing (yes or no) Flee (yes or no) Elevators: passenger freight manufacturer 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 build- ing and its construction may be sent to - 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, f (Signed) n ✓'7� �. T IS TO BE FILLED IN BY BUILDING INSPECTOR Permit No "' 1 76 v issued upon above Application , 192-.._ Classification Disapproved , 192 Reasons• (Signed) Building Inspector.