941 NE 91 Terr (9)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT v f 71 2- /
APPLICATION FOR BUILDING PERMIT / /
Application is hereby wade for the npproval 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 n11 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. whcther 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 ANNA
Registered Architect and /or Engineer ..... ... .... :,,,T,Tt :,.I,.••,,,,,,,, Cf„ -,,.
Name and address of licensed contactor �'t.....: �.....EQQ..��'�Ct....�i ' 71... ��..._ �I.$ i]....1i.QUxti.
Location and legal description of lot to be built on: �
Lot Block Subdivision
Street and Number where work is to be done 91h1 _ a.._.F..�...._91...�.P..rr..a c.e .._..... _.._ . __ ....__ .�.
State work to be done and purpose of building (by floors)... ,.0 Qvf;_.t•ile- •.r'o.tl- •••OUL:x e.I'1t.i ..• -0,.d_.. ctiox. not
.a.nclt ul ng... south ....side .•.af....lowrex.. mot_ xQCa £..R ..- northwest....c. rner
.map_1.�..9Of siate,.whits...ceme. t. and for no other 51.1aeB 1 shingle tA}tkcling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimate Total cost of improvements $..4,.995..0.0 Amount of Permit & 2O.rQQ 18... S.o•uares
Zone cubage required plan Cubage
Distance .to next ne.uest 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 ssith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe 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 uhlic notice
this
PRM9
or notices as are required by the Act. The undersigned agrees to employ only such so • • • rs oa ygq�ib
pcnnit, as are licensed by Miami Shores Village. �/ tilt
Remarks... (Signed
STATE OF FLORIDA,
COUNTY OF DADE. J ss•
Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, per onally 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 true..
Permit No.._ S f` Date er / ......_._._ Read, Sworn to and Subscribed before me.
Disapproved +r"? l " Date
(Signed)
Building Inspector
ROCHON 9k1 _N
Feb. 15 >� 1983 _._...._._......
E r 91._ _ No. T rra C -e. street__..
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member —
Member Member _
Member
to me well known,
Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained (tuts
the Planning Board.
A re.in.pe•ction fee of 31.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty
materials anti /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Owners Name and Address
Registered Architect and /or Engineer
Location and legal description of lot to be built on
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or we plans and specifications herewith submitted for the build
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Anna P, RQQ11.0.11 ..94.1 N,Ea.._._ No 9,1 ... Street _ Terrac e
Miami Shores, Fla, 3313$
Name and address of licensed contractor 4d .a...l.�._L.w...Ak1Jf.31..1.AY. C�1' A�iY.._ 111,.. N,. E ,. ... . ...Court.,.-. .....
_..
Miami, Fla. 3313$
Lot Block Subdivision
Street and Number where work is to be done 941. T. err ace ...._.......
State work to be done and purpose of building (by floors) Labar....and _material ... tQ_remo c.e...pr.e_ ent
r..o.of. tin oaf 1 - 30it felt , mop on
cri th... hot... slate....an apply c ement $h q+o 'fit erpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimates Total cost of improvements S.•.•1�.1S.22..Q.Q 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 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 ul>lic notice
or notices as arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be perfo e• under this
permit, as are licensed by Miami Shores Village. C& L. RO I CODIPA
Remarks (Signed..:
PRES.
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
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. 1
Permit No.._....'t....9...f d Date `- \'aci 1 %.A ..... —._ Read, Sworn to and Subscribed before me.
Disapproved ........ Date
(Signed)
to me well known,
Notary Public, State of Florida
Building Inspector My Commission Expires
•
PLANNING BOARD DATE
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 niter approval has been obtained fmm
the I'Lrnnir.;; 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.
1