11629MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build-
er structure herein described. This application. is made in compliance and conformity with the Building Ordinance of Miami
es 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___) A m e s A. Smith
Registered Architect and /or Engineer
Date October 21 19 69
No.! 2 Street N , _E . 98th St.
Name and address of licensed contractor O b e n o u r Roofing Co. 7352 N o. Miami Ave.
Location and legal description of lot to be built on:
Lot_ Block. Subdivision
Street and Number where work is to be done 672 N . E. 98th St.
State work to be done and purpose of building (by floors) Remove the existing roof and replace with
1 -30 lb. felt, 1 -90 Ib. slate, copper -.fleshings and cement sTiingie-tile.
-- -___ -- - - -_ - -- __ .and for no other purpose.
New Building__ —_____ Remodeling____ Addition Repairs No. of Stories
To be constructed of____ Kind of foundation________ _ Roof Covering 40 s 9 s .
Estimated Total cost of improvements $ 4 , 646.00 _ _Amount of Permit $ —8! 00____
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 post - • for inspection on the site of the wor 'ch public notice
or notices as are required by the Act. The undersigned agrees to employ only such ctors, on work t . _ ' rme under this
permit, as are licensed by Miami Shores Village.
Remarks__________ —_ (Si. -. - nAdd
STATE OF FLORIDA,
COUNTY OF DADE. j ss •
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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. 0 Q _i_L) __ Date ( ___ _ Read, Sworn to and Subscribed before me.
Disapproved __ - Date
(Signed) ----1.)-q1/4-
_-- _l..�
Building Inspector My Commission Expires___
PLANNING BOARD_________.__ _ _____DATE
Notary Public, State of Florida
Chairman ___---_____-___ --
Member -----____.___- -
Member Council Approved___
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.
Member
Member _
Date Disapproved ___
Date