Loading...
456 NE 102 St (3)ApAlication 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 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 AXct and/or Engineer State work to be done and purpose of building (by floors), state exterior colors (submit samples) STATE OF FLORIDA COUNTY OF DADE. 1 SS. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT gtS L F )Ku New Building Remodeling Addition rZamA 9522- (.le_ /AN, 4 I ( ,AA.S. 3 3158 No. (Signed) • Gl \AdA Date 6 - 19 19 a0 Street tJ ) 0 Z S+ Name and address of licensed contractor Location and legal description of lot to be built on: Lot ) 0-f (o Block 91 '' II ,�--� __ Subdivision ( ,s ..e Y 2) /.N/ L ✓ 2 9 6 / ®� d 9 4 Street and Number where work is to be done '�o N e ( ©Z l rwwwit kC _ 4 Repairs No. of Stories To be constructed of A i I Kind of foundation KVA- Roof Covering KVi- Estimated Total cost of improvements $ OM Amount of Permit Sr Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live Toad to be borne by each floor I hereby submit all 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 h by certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's Compensation Act, being Section 5966, Co. piled General i:ws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub -co clots emplo 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 • notice .:s : required by the Act. The undersigned agrees to employ only such subcontractors. on work to be performed under this permit, as are licensed by-'Mra •+ Sho •. ila3 Remarks �L� • .m. , 41, Notary Public. State of Florida 5i -2 9Y /6 7S� -dJ /9 and for no other purpose. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. 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 construction. that he has carefully read the foregoin: application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. r t-' ' "t Date 0 / ' Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member . Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship.