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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‘ 1MIM w •....,�� .....,, ....... ......��,....,��•......��...... a ....,,err ��• are • �r. ∎ v_ �� r r t .rte_ ,..,. r o� MMIWWW iii mgr c v�tirc • rrco mti tulff r� ltf u Nt_ 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 jai , eg:' :° °'%iM greilc° '•i :°.,&°r ' MJt a • vr It uM .... Y = -r • ..•� °'i e ` °' i` It' 19 By 1009 r htgs pector,