585 NE 92 StBUILDING DEPART
APPLICATIU <_J ILDIN3 PERMIT
Application is hereby made for the approval of the aezai ec. statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in complianc:2 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 NS- __H_PO J t-t
Registered Arch -test and /or Engineer
Name and address of licensed contractor_ ��` `_� " '�-_ _
Location and legal description of lot to be built on:
Lo .
Remarks
Chairman
Member _
Member _.
Council Approved --
MIAMI
Block Subdivision.
State work to be done and purpose of building (by floors )_
Ir
Street and Number where work is to be done
Bu, lding Inspector
PLANNING /BOARD
VILLAGE
Member _
Member
Member
Date Disapproved
Date_ -- - .__ _ , 19__ / .
No. 490 -- ---
Street ; ' _ � f! :' . /4 , .„
— - -------- - - - - - and for no other purpose.
New Building Remodeling " __ _ Addition._ .. Repairs.. ___. No. of Stones
To be constructed of Kind of foundation.. _ -- - - ...... __.. Roof Covering
Estimated Total cost of improvements $ -(_ --
p -. - -- - - -- ._ Amount of Permit $. -
Zone cubage required_ - - -- - plan Cubage_
Distance to next nearest building A it be- -s `met rec=d Size of Building Lot__
Maximum live load to be borne by each floor___ -
Y 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, Pennanent 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 subcontractor, on work to be performed under this
permit, as are licensed by Miami Shores Village. � , -
( 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 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 " Date _ `_ - - -' ` `,'
Disapproved ` _ -. _— -` Date____
_ -- '
( Signed)
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires _
.. - -. -DATE
Date
NOTE: A charge of $1.00 will be made for making co- regions or changes :o this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when yr re .n.,pection is made necessary by unproper notice for inspection or faulty
materials and /or workmanship.
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MIAMI =' S VILLAGE
BUILDING ' ":ON DEPARTMENT
APPLICATION U'';-;„ EjILDING PERMIT
Application is hereby made for the approval of the detailec: statement of the plans and specifications herewith submitted for the build-
ing or other stye- re 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, whethe: herein specified or not. A copy of approved
plans and specifications must be kept at puilding during pr - gress of the work.
S lab
rt
Owner's Name and Address
Data
Registered Architect and /or Engineer _ __
Name and address of licensed contractor____ ✓ e! re
Location and legal description of lot to be built on:
Lo. Block
Street and Number where work is to be done
Disapproved
( Signed)
Council Approved ___ __ .
Building Inspe
Date__
ANNING BOARD
Subdivision.
Chairman -- Member
Member _ Member .
Member Member
Date Disapproved
d
No. :5
.DATE
Street
Notary Public, State of Florida
My Commission Expires - -- -
f
--r
State work to b done acid p rpose of building (by floors)_ i J m�_ 3.. f ; �,_ __vt-
P I - - - ✓`_' (422 .6..a , c
.....e._,114 T C R.-i to L. A 1. TE4 ArTe4!sl 1 Tv tttwf.pc, _ t ` +r „ and for no other purpose.
New Building Remodeling %\ _ Addition_ __ .___._.. _. _. Repairs_ ... ...____ .. No. of Stories
To be constructed of Kind of four - - -. _ Roof Covering
-
Estimated Total cost of improvements $____ 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 5968, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will rec;uire 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. /
Remarks �) - ` :. CS
- - - -- -
(Signed) . S_.
STATE OF FLORIDA,
COUNTY OF DANE. 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 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 true.
Permit No q _ Date. `_ _� O � � ' Read, Sworn to and Subscribed before me.
Date
NOTE: A charge of $1.00 will be made for making co-rcr' ions or changes :o this application after approval has been obtained from
the Planning Board.
A re- inspection fee of 51.00 will be charg.d when si..h rc- .n,pection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
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