BUILDING PERMITlionsi.mir INSURANCE AGENCY
Gentlemen:
AMH/eg
Encl.
cc: Frank J. Lu Bein
32 N. E. 91 Street
Miami Shores, Florida
SAFETY
esr. ERVICE
AVINGS 192°
13th FLOOR
PAN AMERICAN BANK BLDG.
MIAMI 32, FLORIDA
July 10, 1950
Miami Shores Village
10050 N. E. 2nd. Avenue
Miami Shores, Florida
Re: Frank J. Lu Bein
Policy # 18179
Enclosed, herewith, please find the certificate of
insurance covering the above named for the completion
of your records .
Very truly yours,
HOLEY SURANCE AGENCY
A. M, Hamil,
AMk IcAr I CASUA D c M PINY
P ERICq �°
UAY.TY
..NCO. CONSERVATIVE RATES - PREFERRED RISKS ONLY
O.i.NP0
AMERICAN BUILDING
ORLANDO, Florida
A STOCK COMPANY
HORSLEY INSURANCE AGENCY
TELEPHONE 82.7581
13TH FLR. PAN AMERICAN BANK BUILDING
117 N. E. 1$T AVENUE
MIAMI. FLORIDA
Miami Shores Village
Miami Shores, Florida
Gentlemen:
AMH /it
encl.
cc: F. J. LuBien
1 July 1950.
Re: Frank J. LuBien
32 N.E. 91st Street,
Miami Shores, Fla.
Attached hereto please find Certificate of
Insurance for American Fire and Casualty Company policy
No. SMC 8928, for the insured in caption, for the
completion of your files.
Trusting you find same in order, we remain
Most sincerely,
HORSLEY INSURANCE AGENCY
A. M. Hamil �J
Nance of Assured
Description of work covered
M- 02J- 1 -5J -H
To Miami Shores
Address mimni Shares, Florida
This is. to certify that the following described policies, covering as stated,, have been issued to the named
herein by the AMERICAN FIRE AND CASUALTY COMPANY, and are now in full force and effect.
FRANK J. LuBIEN
o f 32 N. E. 91st Street, Miami Shores,. Florida
CARPENTRY
Location udcere cork is to be done STATE OP FLORIDA
AMERICAN : FIRE WAND. > CASUALTY 4COMPANY
- RICAN BUILDIM ORL4AW - FLORIDA
CERTIFICATE OF
Date June 26,
In the event of any material change. in or cancellation of said policies, the A'nerican.Fire and Casualty Conipwzy will make
every effort to notify the party to whom this Certificate is addressed of such change or cancellation, but the American Fire
and Casualty Company undertakes: no responsibility by reason of any failure to do so.
AMERICAN FIRE AND ,CASUALTY COMPANY
HORSLEY INSURANCE AGENCY /
By - �-
1q
gent,
Po /icy
MAwber
Effective
Date
Expiration
Date
Limits of Liability
- -
WORKMEN'S COMPENSATION
fANUFACTU ER "S a,.d.CC ?DTRACTCR'
D; O D I L Y I V, UR Y
$ 10,000. One Person
20 , 000. One Accident
MANUFACTURER 'Sand CONTRACTOR'S
PROPERTY DAMAGE '
+MC -8928
6 - 20 - 50
20 - 51
$1,000. One Accident
$10,000. Total Aggregate
w
$
Nance of Assured
Description of work covered
M- 02J- 1 -5J -H
To Miami Shores
Address mimni Shares, Florida
This is. to certify that the following described policies, covering as stated,, have been issued to the named
herein by the AMERICAN FIRE AND CASUALTY COMPANY, and are now in full force and effect.
FRANK J. LuBIEN
o f 32 N. E. 91st Street, Miami Shores,. Florida
CARPENTRY
Location udcere cork is to be done STATE OP FLORIDA
AMERICAN : FIRE WAND. > CASUALTY 4COMPANY
- RICAN BUILDIM ORL4AW - FLORIDA
CERTIFICATE OF
Date June 26,
In the event of any material change. in or cancellation of said policies, the A'nerican.Fire and Casualty Conipwzy will make
every effort to notify the party to whom this Certificate is addressed of such change or cancellation, but the American Fire
and Casualty Company undertakes: no responsibility by reason of any failure to do so.
AMERICAN FIRE AND ,CASUALTY COMPANY
HORSLEY INSURANCE AGENCY /
By - �-
1q
gent,
The above policies cover the assured's operations in connection with
TO:
L
FORM C -411 RN: 10M- 791.40
CERTIFICATE OF INSTTRANCR
ALL WORK DONE IN THE STATE OF FLON DA
Miami Shores Village
10050 N. E. 2nd Avenue
Miami Shores, Florida
STATE OF ALABAMA 1
Jefferson County J
This is to certify that the following described policies, covering as stated, have been issued by
EMPLOYERS INSURANCE COMPANY OF ALABAMA, INCORPORATED, and are in force
at this time:
ASSURED FRANK J. LU BIEN
Workmen's Compensation Policy WC— ____18.79_ ______ *
POLICIES Public Liability - - Policy PL— NONE LIMITS $ NMI
Property Damage - - Policy PL— NOM LIMITS $__
* * * * * * * * * * * *
Policies Effective:____ J am . @ _ _ 4 _ _ . _ _ . . Q ______Policies Expire: • J @___
In the event of any material change in the policies, written notice will be given the persons to
whom this certificate is addressed.
This the 8 th day of_____ -_- July , 19' _..,§..Q.
EMPLOYERS INSURANCE COMPANY OF AL
HMS r::, Y INSURANCE
BAM A, INC.
ed Agent.
It is he iy understooDfand agreed tha* o
cancel]. ion or material change shall baeom -
effective except upon ten (10) days
advance written notice by registered mail
to Miami Shores Village, 10050 N. E. 2nd
fi venue, Miami 6 hores, Florida
OWNER'S NAME
NEW CONSTRUCTION
TYPE
C % 5
PRESENT ADDRESS
LICENSE NO.
PHONE NO.
JOB LOCATION (ST. OR AVE.)
3 2 t.1 . 9 l '-Sr* S 1 .
//11 � II D SCRIPTI 1/
�+ CU. b0. 1 1I1 , (e i•,. 'F %.`/ I, • I(a_G +Of`! d L.-14A
,� I/_ .4 LQT o-d . .
t N '/z aa c) ( I o
BLOCK
- `�
SUBDIVISION
4 4 i / - .1.1, � c� tFe 2 er
GENERAL CONTRACTOR
J o; crk,... 14A42012-1, S
SUBMITTED TO PLANNING BOARD
ADDRESS
( 4- o o iJ. �:. • 13, I
PHONE NO.
LICENSE NO.
3 b v
/
BUILDING PERMIT NO. 't'3 1
DATE
1-- (..O
O •
PERMIT FEE $ ( 0
BUILDER'S BOND
4 ` ,
NO. L 4 ') & DATE 7- `
4DO. T y .^�
ZONE REQUIREMENTS
CU. FT.
rr
1, 911.t� rib T,
PLAN CUBE . ido CU. FT.
be
EST. COST $ 14d0
DRAW NGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: C• iT M 4,2K.. e‘._.
BUILDING PERMIT AND INSPECTION RECORD - MIAMI SHORES VILLAGE
DAT=
- VO
NEW CONSTRUCTION
TYPE
C % 5
STORIES
°
ROOF CONSTRUCTION
"T , -..Is
INTERIOR CONSTRUCTION
1 F`o 2t0 A Zeo.....
REPAIRS
//11 � II D SCRIPTI 1/
�+ CU. b0. 1 1I1 , (e i•,. 'F %.`/ I, • I(a_G +Of`! d L.-14A
DESCRff'TION
ALTERATION
1f
ADDITION d. 1 . 1 c.0.1. c.0.1. 1. J t n �J _ �x Po /I St tl /ytq�/. r ,q L o _
SUBMITTED TO PLANNING BOARD
APPROVED
REJE
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SURMITTFO TO VILLAGE COUNCIL
REMARKS
,[
CERTIFICATE OF OCCUPANCY NO. /�T
ISSUED ��� f.-6, �
BY
TO ILO�GOL� (. �/ Np ,,,,, ) l,$O►�
TO
DRAW NGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: C• iT M 4,2K.. e‘._.
BUILDING PERMIT AND INSPECTION RECORD - MIAMI SHORES VILLAGE
DAT=
- VO
INSPECTIONS
DATE
BY
INSPECTIONS
DATE
BY
FOUNDATION
$
SEPTIC TANK
ROOF
TEMPORARY SERVICE
$
BEAMS & LINTELS
$
TUB & TOP OUT
POOL
SOLAR HEATER
$
FRAMING
$
GAS
AIR COND.
MOTORS
$
FINAL
$
FIXTURES
CLEAN UP
SEPTIC TANK
$
SLAB
It
SOLAR HEATER
SLAB
SPECIALS PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
RE- INSPECT
BY
$
SEPTIC TANK
FEE
TEMPORARY SERVICE
$
SEWER
$
TUB & TOP OUT
$
SOLAR HEATER
$
RANGE CONN.
$
GAS
SEWER
MOTORS
$
$
FIXTURES
e
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
DATE
FEE
TEMPORARY SERVICE
ROUGHING
$
TUB & TOP OUT
$
RANGE CONN.
SEWER
MOTORS
RANGE CONN.
$
FIXTURES
SEPTIC TANK
$
It
SOLAR HEATER
FIXTURES
GAS
CONTRACTOR . D.. C. E ..—(sc..'� C_ 6 a_
PHONE
PERMIT NO. (DATE G I „ (..-, ®
FEE $ c,
NEW BLDG. 1 ALTERATION 1 ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
ROUGHING
$
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
RANGE CONN.
$
FIXTURES
$
It
INSPECTIONS
DATE
BY
RE- INSPECT BY
RE- INSPECT
BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
9 L��•59 BUILDING INSPECTIONS
CONTRACTOR
PERMIT NO.
NEW BLDG.
DATE
1 ALTERATION 1 ADDITION
. APPROVAL TO POWER CO. FOR SERVICE DATE
PLUMBING PERMITS & INSPECTIONS
PHONE
FEE $
REPAI RS
ELECTRICAL PERMITS & INSPECTIONS
BY
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
N° 1141
Miami Shores Village, Florida, 10 -1-60
Owner, Agent or Tenant of Building ROSCO T. KNOWLSON
Lot W j of 8 Block 9 Subdivision Miami Shores
Stree f A ,, 77 d f and of 10
dress 32 NA. 91st Strsst
Approved use by occupancy Florida Room Addition
Remarks. 431
This Certificate of Occupancy is issued to the above named Owner
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling of buildings or structur
Pla# Cube X3RIX 1911
Tax Value 956
BUILDING DIVISION
Date 4— /%5 ,19..4e0
1 I 11
Owner's Name and Addres 7 K40 IV L .Q",) No...3 7 - Street. . 6 ' 9 I 4 7.
--- ' ' • .4
. . Registere- Architect and/or Engineer
Name and address of licensed contractor.J.A.‘it. -41C. r.i.,) / 00 AL a /3 1 S 7
11-1 --- - 4 q:ocation and legal description of lot to be built on:
1 1 ' .1,, Ae . .
Mock .9 Subdivision. MIAAD S 110 rz a -s
Stret and Number where work is to be done 3 z- A/& 0 1
4. State work to be done and purpose of building (by floors) 1 ii c...13 s
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval 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 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.
and for no other purpose.
New Duilding Remodeling Addition 1.e.'" Repairs No. of Stories /
To be constructed of.-5..1.4010.V.e. Kind of foundation .c. Iv Covering 7; 46:-
Estimated Total cost of improvements $ / ` 1,6 '''' Amount of Permit $ .1
Zone eubage required _Plan Cubage - 'ilziet A6=fei. 19/1.c.
,
Distance to next nearest building Size of Building Lot 7 0 X 1 ' * 8 0 0 x Co 7. %.,, I
Maximum live load to be borne by each floor
I hereby s mit all the Tans and specifications for said building. All notices with reference to the building and its construction may
be sent to L 4 LE) 4 E(-Z' coep. .J4400 Ai E / 3 1 S 7;
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 th. work to be performed under is permit; and will post or cause to be posted f inspection o the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such tcontractorj on wor • to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks
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-gplication, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No 44 2- Date 7-4 e, Road, Sworn to and Subscribed before me.
Disapproved Date._
( Signed)
Building Inspecto
MIAMI SHORES VILLAGE
sttHE aci)6 As p_oo
(Signed)
Notary Public, State of Florida
My Commission Expires
P ANNING BOARD D4
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 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.
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval 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 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 Q C__0._t=_._. Kivo l / L SQ n�
Registered Architect and /or Engineer / }
Name and address of licensed contractoriA Axed .._... J4ot _) /1(& /3 / S 7'
Location and legal description of lot to be built on:
• f oF 8 - . 4 �� of Block
Subdivision NI1A /aT C , ,? HO g E S
At• z. OF. rO `
Street and Number where work is to be done s Z I .9 1 S •
State work to be done and purpose of building (by floors) 1 ST)' CBs 1 A • •e'Okj.
New Building
Remarks
MIAMI SHORES VILLAGE
(Signed)
Date
No $ Z Street AX r E J 5 T
and for no other purpose.
Remodeling Addition ./rte Repairs No. of Stories /
To be constructed of SM. ,C.d*Y4. Kind of foundation •C Rog Covering 7/GC
Estimated Total cost of improvements $ / ✓ oo b2• Amount of Permit $ I O
Zone cubage required .Plan Cubage 1100104 eo 9
Distance to next nearest building Size of Building Lot .7.6.- 0 4. 1 ' "fr 6 (0 7. ..
Maximum live load to be borne by each floor
I hereby su mit all the lans and specifications for said building. All notices with reference to the building and its construe ion may
be sent to C.. _ AJZ,Ej s 13 it. A G C 0 RP - / it D U /il E / 3 / S7.7 IV.
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 in ction on the site of the ork such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcs actors, on ork to performed under this
permit, as are licensed by Miami Shores Village.
, 19._6p
STATE OF FLORIDA,
COUNTY OF DADE. j 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. /
Pe No 4 '3 2 Date 7 G ' (O j� Read, Sworn to and Subscribed before me.
Disapproved q Date
Notary Public, State of Florida
( Signed)
Building Inspecto ' My Commission Expires
PJ4NNINC BOARD DATE
Chairman / Member r
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 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.
Francis J. LuBien
167 HE 59th St s Jr.
L-9 and iJJ of L-
ELPORTAL SECTION 3 B-9
FHA No. 09 -049618
°® Chandler (plumber)
Date sent J 17, 1950
AS RST FEDERAL SAVINGS
IATIOiv OF MIAMI & LOAN
B e,
Loan Officer
r
OWNER'S NAME
+'W 3I 1, FRS" '`
PRESENT ADDRESS
167 N. E. 5 Street
LICENSE NO.
a - o ,
PHONE NO.
JOB LOCATION (ST. OR AVE.)
$2 N. E. 91st Street _
LOT
9 & Wi 8
BLOCK
9
SUBDIVISION
I El Portal Soot. $ .
GENERAL CONTRACTOR
Owner
ADDRESS
167 N. E. 59th Street
PHONE NO.
/46289
LICENSE NO.
3 O -B
BUILDING PERMIT NO. 9408
94
DATE 6/5/50
App
PERMIT FEE S 17.00
BUILDER'S BOND �j�
NO. 1009 DATE 5! / 2 4x5 0
ZONE REQUIREMENTS 179500 CU. FT.
PLAN CUBE 19054 CU. FT.
EST. COST S rim 000,000
DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: JDH
DATE
6/3/50
X
NEW CONSTRUCTION
TYPE
CBS
STORIES
1
ROOF CONSTRUCTION INTERIOR CONSTRUCTION
Tile (Pine Floors - Plaster Walls
DESCR IPTION
III/ ' IY Ra - Din - Rai - Kit - Jal. Porch - 2 Bed Ems - 2. Baths- 1 ear att. g s
ALTERATION
DESCRIPTION
w /utility room '
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
CERTIFICATE OF OCCUPANCY NO. 958
ISSUED 9/19/50
BY JDH
TO Frank LuBien, 167 NE 59th St.
BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE
INSPECTIONS
•ATE ,
l3dF
R _ I SP
BY BYY
RE- INSPECT
BY
FOUNDATION
. I II�D, So,
` ✓*
. 16 /5
al
TEMPORARY SERVICE
$
BEAMS & LINTELS
6 �n
V/�1
950
9501
6/11/50
$ 1.00
SEWER
FRAMING
�f (�_��
'
SOLAR HEATER
$
FIXTURES
$
GAS
$
$
$
'INSPECTIONS
FINAL
41 Ygi ;
I 7
BY
RE•INSPECT
BY
RE- INSPECT
CLEAN -UP
ROUGHING
7/6/50
JDH
ROUGHING
CONTRACTOR T f:h AnfI11 Ar
PHONE
1 WA r l
PERMIT NO. 947,4 1 DATE p /7/50
FEE $ 9.75
NEW BLDG. X
ALTERATION
I ADDITION
REPAIRS
SPECIAL PERMITS
PERM! f NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
$
SEPTIC TA1CRutiYllana
950
9501
6/11/50
$ 1.00
SEWER
$
$
SOLAR HEATER
$
FIXTURES
$
GAS
$
$
$
'INSPECTIONS
$
INSPECTIONS
DATE
BY
RE•INSPECT
BY
RE- INSPECT
BY
ROUGHING
7/6/50
JDH
ROUGHING
7/1 50
GAS
H. W. HEATER CONN
SEWER
RANGE CONN.
SEPTIC TANK
6/13/50
JDH
SOLAR HEATER
FIXTURES
�= �j,
1 1 gt15 : �[�✓
FIXTURES & FINAL
• ��
%Silt
I
t ...-
' r.
CONTRACTOR L. P, Benton
PHONE
PERMIT NO. 9626 DATE 7
FEE $ 12.25
NEW BLDG. 1 ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
$
RANGE CONN.
$
MO.TORS
$
FIXTURES
$
$
'INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
ROUGHING
7/1 50
tT1
Ma
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
• ��
%Silt
I
t ...-
' r.
APPROVAL TO POWER C lErC2111E1MaillitilintETE,
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
ELECTRICAL PERMITS & INSPECTIONS
PAID BY
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
�
�}'3"s' nlr T�.:ti* =^ ^ 1 , ( ;
it `1
/ 9J —/
W /a.
I st - 3 J —� /
t1/o2
.4- 1.2.- 3
ADDRESS 32 N. E. 91st St.
LEGAL
L2 t *t ee£. --,
94*g B1. 9 RECORD GARBAGE TAX'
Application is hereby made for the approval 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 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.
Date A y 2 -9 19_�_�
ppi'`` ,, y
Owner's Name and Address___ r1N �Y �1 N A � j �Y ^ No 1b ( Street \ �
ly
Registered Architect and /or Engineer �? , ' , "dO [ r h T
Name and address of licensed contractor �� �- �QQ1L 0%0 0 Ert. - Q tL c) ( L.
Location and legal descri tion of lot to be b ilt on: p Ti C�
Lot_ t!1l Block Subdivision �._Lt C R * tle
Street and Number where work is to be done 3 1\! _ i �1 _ _ _________________._
State work to be done and purpose of building (by floors V Rft
New Building Remodeling
To be constructed of _ . Kind of foundation
founnd
Estimated Total cost of improvements $ IS
_�_LlY�
Zone cubage required
Distance to next nearest building
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI 8JRES VILLAGE
BUILDING INPWCTION DEPARTMENT
-APPLICATION FOR BUILDING PERMIT
and for no other purpose.
Addition Repairs No. of Stories_—____{.
14C- Roof Covering 1 of f�2
17 Om
TT Amount of Permit $
{ 7 _6{!) _Plan Cubage_ _
F- y Size of Building Lot .6
Maximum live load to be borne by each floor
I hereby submit all the plans and urcifications for said building. All notices with reference, to the building and its construction May
be sent toRA__1.�1� I1 1�l__ S I�M! .
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 public notice
or notices as are required by the Act. The undersigned agrees to employ only such s} n work to performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, bein , by me first duly sworn, u. •n oath deposes and says that he is the__
of the above • crib •d co , + ; , uction, that has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him state
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
1L,z9
Building Inspec o ` ""JMy Commission Expires
to me well. known,
PLANNING BOA D DATE
Chairman Member
Member Member
Member Member
Council Approved ate Disapproved Date
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.
Ak'F 1 DAV,I
STATE OF FLORIDA) SS
COUNTY OF DADE )
ViWAL__I=V11.7.0 of the Village of I end Shore,
County of Dade and State of Florida, being duly sworn, doth depose and say,
that under the provisions of Ordinance No. 185, dated June 15, 1948, amend-
ing paragraph (d) of Section B -368 of Ordinance No. 97 of the Build' Code
of Miami Shores Village, he de Tres to build
on Lot Q 1 W C Block of tiA. BTg1� _ SIVC Subdiv
that he is the owner of said property, and will be the owner of said
'Eb1Q400C that to will do the work personally, sand that
he will, at such times as are required by the Zoning and Building Director : -
1. File plans and specifications and obtain approval of the
Planning Board and the Building Inspector.
2. Apply for and secure a Permit.
3. Pay the required fees.
4. Execute the work in accordance with the provisions of this
Code.
5• Apply for inspections.
6. File with the Building Inspector certificates that provision
has been blade to carry the necessary Workmen's Compensation,,
Public Liability and Property Damage Insurance.
7. File with the Building Inspector as the job progresses certi-
ficates showing the payment required by the Federal Social
Security Act to the State of Florida or the United States oS
America.
6. Assume the responsibility of not employing other than prop '1
licensed contractors by Miami Shores Village for any part 6.
portion of the work.
9. l,t set himself up as a "contractor ".
10. Sign an affidavit before commencing work to the effect that
he has read this Article and will do the work personally and
observe all of the requirements of the Building, Electrical,
Plumbing and Zoning Codes of Miami Shores Village. Such
affidavit to be properly notarized upon blanks to be supplied
by the Building Inspector.
11. In order to prevent abuses and subterfuge the right of such
owner - builder as herein provided, is limited to but one
owner - builder permit each 2 years, and where an owner - builder
has once exercised the privilege herein conferred no second
application for o ner- builder permit shall be granted in less
than 2 years, unless the applicant is qualified as a l cens$d
General Contractor under the applicable Ordinances of said
Village.
And Further this Deponent says not:
SUBSCRIBED AND SWORN TO 131701T; KE this
195
NOT*' A1' F FLSRIDA AT
MV COMMISSION EXPIRES AUGUST 15, 1952.
Address
in consideration of the issuance to me by Miami Shores Village, Florida, of as permit or rmits to construct o repair a building or
74 buildin at the follo g, ✓ / n Ars C
s do hereby deposit with Miami Shores Village, Florida, the sum of SL , and I agree with said Village that, when such Construction shall have
c been completed by me within the meaning of the ordinances of saki Village, I will clear all premises and repair any Village property damaged by me,
4 used for the deposit of material or equipment in the construction or repair and that, if I do not so clear and 'repair such premises immediately upon the
completion of such constructs thin; t j l a meaning of such ordinances, the Village may clear. and repair the same and pay the costs of such clearance and
! repairs o t of the aforesaid, and return the remainder to me; and that, if I shall clear and repair said property immediately, as aforesaid, then
'" sai shall be returned to me.
i?.:
tie
WITNESS MY HAND and Seal at Miami Shores Village, Florida, this day �, �� /F1‘
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Issu
Amoun
No. Houses
KNOW ALL ME
19_—
Y THESE PRESENTS, that
WHEN CLEARED AND REPAIRED BY TIME VILLAC
tami cihores9Illage
F L O A 1 D A
BUILDER'S BOND
,..,...
s (Seal
INSTRUCTIONS TO BUILDER —When above mentioned construction is completed and the premises are cleared nd repaired take this bond to the
4 Village Building Inspector and obtain his approval, after which Miami Shores Village will refund your money in accordance with the above agreement.
3 VILLAGE BUILDING INSPECTOR'S APPROVAL
I hereby certify that the construction contemplated under this Bond, has been completed and that the builder thereof has caused
the surrounding premises to be cleared and repaired in as good condition as they were before commencing said construction.
rr
Amount of Bond $
Cost of clearing and repairs done by Village $
Balance due Builder $ ` Cancelled
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