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152 NE 93 St (8)LOT 8 & W5' 7 & E25' 9 MIAMI SHORES SEC 1. AMD FOLIO # 11 3206-13 3100 6 • AJK/A ' N.. E. 93rd ST. HISTORICAL LANDMARK COVENANT IN CONSIDERATION of the designation of the real ';`' property hereinafter described as a historical landmark by MIAMI SHORES VILLAGE, FLORIDA, the undersigned, being all of the owners of the said real property, for themselves, their heirs, executors, administrators and assigns, do hereby jointly and severally covenant with Miami Shores Village, its successors and assigns, that no structure presently situated on the fol- lowing 'described real property shall be demolished, moved,.or changed in the exterior appearance by addition, reconstruction, alteration or maintenance, nor shall any trees situated on said real property be•destroyed or.moved until an application for a certificate of appropriateness has been submitted to the Hi Preservation Board of. Miami Shores Village and has. been approved by that Board, or the Village Council on appeal. Said property is legally described as follows: BLK 23 • This covenant shall run with the land and shall terminate only upon the written consent of Miami Shores Village, or its successors and assigns, and the undersigned do expressly consent to the filing of this document in the Public Records in and for 'Dade County, Florida IN WITNESS WHEREOF, we have hereunto set our hands and ,� seals on the 25th day of JANUARY , 1988 . WITNESSES: STATE OF FLORIDA • COUNTY OF DADE BEFORE ME, the undersigned authority, personally appeared Valerie Casuso Schields and who being by me first duly sworn, did state under oath that they are the persons described in and who signed the foregoing . Historical Landmark Covenant and that they signed the same freely and voluntarily for the purposes therein expressed. My commission expires: NOTARY PUBLIC, STATE OF FLORIDA. • MY COMMISSION EXPIRES APRIL 16, 1988 BONDED MU STEMBLER-ADAMS & SNEEI 2 sb 4 4 V54/ CArl PUBLIC STATE OF FLORIDA AT,'i,ARG» , n C: :TY OF MIAMI FLORIDA (Little River District) OFFICE OF BUILDING INSPECTOR APPLICATION FOR BUILDING PERMIT (A copy of this Application, together with one copy of plans and specifications, must be kept at building during progress of the work) Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub- mitted for the building or other structure her: in described. This application is made in compliance and conformity with the Building Ordinance of the City of Mf imi, Florida, which said Ordinance was approved July 7th, 1919. All provisions of the Laws of the State of Florida, all ordinances of the City of Miami, and all rules and regulations of the Building Department of the City of Miami, shall be complied with, whether herein specified or not. Date ' / , 192 Owner's Name and Address Street -7 / No Architect !� Name and address of contractor or builder Location and legal description of lot to be buil ; on: Lot Block Street and Number where work is to be crone_ Purpose of building (by floors)_ =� New Building Remodeling Subdivision Addition ______ Repair__ Number of Stories Estimated cost of Improvements (not including furnishings) $_,L_ Type of Construction ____ Roof covering Foundation Number of persons to he accommodated (maximu n) per floor ____ Size of building lot_ street) Heating system, if any (kind) _ _ _ Plumbing Elevators: passenger freight__ - _ __ _Manufacturer Maximum live load to be borne by each floor I hereby submit all the plans and specifica ;ions for said building. All notices with reference to the building and its construction may be sent to In this space give lot dimensions; make sketc i of ground plan, and distance of building from all lot lines. Distance from next nearest ad joining building (from all sides except (Signed) (Signed) _- _and for no other purpose. Elec. STATE OF FLORIDA, SS. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowl- edgments, personally appeared 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 building, that he has carefu'ly read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Read, sworn to and subscribed before me, (Signed) Notary 'Public. My commission expires THIS TO :3E FILLED IN BY BUILDING INSPECTOR Permit No _____ _ _issued upon above Application , 192 Classification Disapproved , 192._ _____ Reasons: Building Inspector. 0 REQUEST FOR INSPECTION Company PHONE Job Address Inspection Time Ready A.M. P.M. Date Ready UILDING LECTRICAL LUMBING 'weer of uilding MIAMI SHORES VILLAGE, FLORIDA DATE 194 PERMIT N° 8590 Work to be performed under this Permit rchitect — :ontractor /...1 • Builder .egal Lot Bl. iescription ddress of i Value of I Amt. of , ' uilding ,. Project 1 Permit ' •- This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- - tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked any time if the work is not done in compliance with such ordinances or '.f the plans are changed without authorization. A further condition upon which this ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and : gulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- Subdi- vision Contractor's License No. b his for work done y is agents, servants or employees. / ` Signed. •' '` ' By INSPECTOR , In consideration of the issuance to me of this permit I agree to pert orm the work covered hereunder in compliance with all ogdii noes and regulations ertaining thereto and in strict confo ity with the lans, drawings, statements or specifications submitted to the proper authorities ofMMiami Shores Village. i accepting this permit I resp sibility i a,Ywork doge by either myself, Fly age)►t, se nt or employee. CONTRACTOR OR BUILDER BY AUTHORITY Y t__.• : PA I D BY Y YEAR A ANNUAL TAX P PERIOD USED A AMOUNT PAID D DATE PAID N NUMBER :.., F *N 1 1940 LOCATION 152 11. • C357:1 :4t:oc 0 t 1 GARBAGE TAX RECORD 152 N. E. 93rd St. By- R. Bloedorn /9s/ year annual tax period used amount paid date paid receipt # /07 0 /a -J/ -S7 /A? v No. STREET � - PART OF LOT LOT BLocx SUBDIVISION BUILDING TO BE USED FOR FRONT HEIGHT STORIES TYPE OF CONSTIWOTION BUILDING TO BE USED FOR ROOF COST OF BUILDING PERBirr FEE DEPTH Frame. Tile Coillrete, Stucco ideas% pts., Stores,..$otel BUILDING PERMIT Owner of Building Dated • + C= { Miami Shores /0? f , 19. Village, Horida, Architect Contractor or Builder PROPOSED LOCATION DESCRIPTION OF BUILDING This permit is hereby issued to I 4.,-, _ • To r ` - the building above described, as per application, Flans and Specifications heretofore filed in this office. This permit is granted' upon the4- press condition that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance and compliance with the building laws Of the, State of Florida and with this building ordinances and zoning laws of Miami Shores Village, and rules and regulations of the building dephstinent of Miami Shores Village. This permit may be revoked at any time upon the violation of any provisions of said laws, ordinances or rules and regulations, or, Upon -shy change in the plans and spe (cations unauthorized by the building inspector. MIAMI SHORES VILLAGE OFFICE OF BUILDING INSPECTOR // ". " : 193.... NI? 208 BUILDING INSPECTOR In consideration of the issuance to me of this building permit I hereby agree to do the proposed construction in- strict conformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building department of Miami Shores Village. i ; ,e (SEAL) BUILDING ELECTRICAL PLUMBING Owner of Building _ Architect Contractor or Builder Legal Lot Bl. Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 3488 Work to be performed under this Permit IS .•,,f- -rich.,- may ha in v, :":.a P..73“. nc y li io con;ull yuu; 'char oince before starting the work author" Subdi- vision Value of Project ,u this permit DATE 194 Contractor's License No. Amt. of Permit This permit is granted to the contractor or builder named above to co istruct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and _ -hat he assumes responsibility for work done by his agents, servants or employees. M Sii2ned• - By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- ions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores illage. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. BY AUTHORITY FRONT DEPTH HEIGHT STORIES 1'YI'E OF CONSTRUCTION Bt ILfING 'r0 BE USED FOR ROOF COST OF BCILDrNt: t'I:It)MIT FEE Frame,' Tile''E oncrete. Stucco Resi fence. Apts., Stores, Hotel J •mo t;,.. BUILDING PERMIT • No. Dated This permit is hereby issued to STREET ' , ,/,/.1 c G - Owner of Building r , Architect a .. Miami Shores Village, Florida, , 193.... Contractor or Builder PROPOSED LOCATION Papa. of Loy DESCRIPTION OF BUILDING To }+r the building above described, as per application, Plans and Specificati ons heretofore filed in this office. This perrnit is granted upon the ex- press condition that all facts stated in the application are true and th at the construction complies strictly with the plans and specifications submitted, and in accordance and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and regulations of the building der artment of Miami Shores Village.. This permit may be revoked at any time upon the violation ldi of any provisions of said laws, ordinances or rules and regulations,.or upon any change in the plans and specifications authorized by the buing inspector. , 0 . 19. Lor BLOCK MIAMI SHORES VILLAGE OFFICE OF BUILDING INSPECTOR N° SUBDIVISION 78 BUIL1)IN Sl'):OTOR .f In consideration of the issuance to me of this building permit I hereby agree to do the proposed construction in strict conformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance width all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami S hores Village and all rules, and regulations . of the building department of Miami Shores Village. (SEAL) No. STREET - i PART or Low LOT BLOCK SUBDIVISION Roo CosT of BUILDING PEBIIrr Fax FRONT DEPT!: HEIGHT STORIES TYPE OF CONSTRUCTION BI_ ILDING TO BE USED TOR Roo CosT of BUILDING PEBIIrr Fax Frame; Tile-- 03ncrete, Stucco Residence, Apts., Stores, Hotel 0 0 gy p. f """4................e BUILDING PERMIT Miami Shores Village, Florida, , 193.... Owner of Building Architect Contractor or Builder PROPOSED LOCATION This permit is hereby issued to the building above described, as per application, Plans and Specifications heretofore filed in this office. This permit is granted upon the ex- press condition that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and regulations of the building department of Miami Shores Village. This permit may be revoked at any time upon the violation of any provisions of said laws, ordinances or rules and regulations, or .upon any change in the plans and specifications unauthorized by the building inspector. In consideration of the issuance to me of this building permit I hereby agree to do the proposed construction in strict conformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building department of Miami Shores Village. Dated 19 DESCRIPTION OF BUILDING elk MIAMI SHORES - VILL•GE OFFICE OF BUILDING INSPECTOR To- N? 78 BUILDIR Poi MO TOR (SEAL) FRONT DEPTH HEIGHT STORIES TYPE OF CONSTRICTION . BUILDING TO BE USED FOR Roor ................■........■ COST or BUILDING PED31 rr PEE Frume, ii Concrete. Stucco , Resiaence. Ants.. Stores. Rotel • BUILDING PERMIT NO. 6A Owner of Building Architect Contractor or Builder , • ' STREET MIAMI SHORES VILLAGE OFFICE OF BUILDING INSPECTOR Miami Shores Village, Florida, `77 , 193.... PROPOSED LOCATION PART OF LOT LOT BLOCK DESCRIPTION OF BUILDING N? SUBDIVISION 2QS This permit is hereby issued to . To ,_,4Y= /...? ' , the building above described, as per application, Plans and Specifications heretofore filed in this office. This permit is granted upon the ex- press condition that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and regulations of the building department of Miami Shores Village. This permit may be revoked at any I ime upon the violation of any provisions of said laws, ordinances or rules and regulations, or,-dpim 1.ny change in the plans and specifications , authorized by the building inspector. In consideration of the issuance to me of this building permit I hereby agree to do the proposed construction in strict conformity with the application and plans and specifications thereof heretofore by me subir itted, and in' compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building department of Miami Shores Village. BUILDING INSPECTOR (SEAL) STATE OF FLORIDA DEPARTMENT OF STATE Division of Archives, History and Records Management DS- HSP.3AAA Rev. 3.79 FLORIDA MASTER SITE FILE Site Inventory Form FDAHRM 802= = 1009= = Site No. Site Name 830= = Survey Date 8506 820= = Address of Site: 152 NE 93 St., Ivilarni Shores, Fl 33138 905= = Instruction for locating on 3 _s id.e of NE93 St. between NE 1st Ave. & NF' 2 nd Ave. 813= = Location: Miami Shores Sec. 1 A.d. , 23 — 8 &W 5' of 7 & E25' 9868= = subdivision name block no. lot no. County: Dade _ 808= = Owner of Site: Name: - - , - Address: 152 NF 93 St., Miami Shores, F1 33138 Type of Ownership Recorder: Name & Title: Address: private , 848 = = Recording Date 832= = Newton, Margo, Chairman, & Stofik, Marty MSHPB Condition of Site: Integrity of Site: Check One Check One or More ❑ Excellent 863= = *] Altered . 858= = ❑ Good 863= = ❑ Unaltered 858= = K1 Fair 863 = = Original Site . 858= = ❑ Deteriorated 863= = ❑ Restored( ) (Date: )( )858= = 911 = = 902= = 818= = Original Use private resid. 838= = Present Use private resid. 850= = Dates: Beginning ,. 1926 844= = Culture /Phase American 840= = Period 20th Century 845= = ❑ Moved( ) (Date: )( )858= = NR Classification Category Building 916= = Threats to Site: none Check One or More El Zoning( )( )( )878. = ❑ Transportation( )( )( ) 887788: _ El Development( )( )( )878= = ❑ Fill( )( )( ) _ ❑ Deterioration( )( )( )878= = ❑ Dredge( )( )( )878= _ ❑ Borrowing( )( )( )878= = ❑ Other (See Remarks Below): 878 = = Areas of Significance: Architecture 910= = Significance: Structure is a fine example of the use of the Mediterranean Revival design for a small, one -story residence. Noteworthy features include a 11/2 story entry tower with decorated frieze and decorative curvilinear parapets on E side and on W side of porte cochere. One unusual feature is an elongated triangular transom over French doors leading to terrace, with a cast masonry lion's head at the point of the triangle. Structure is in scale and character with the reighborhood, and is one of the homes built as part of the original Shoreland development of Miami Shores. Township Range Section 812 = = 53S 41E 1 ARCHITECT Cobelli, Edwin, G. (Miami, F1) BUILDER Bloedorn, R. (Miami, F1) STYLE AND /OR PERIOD Mediterranean Revival PLAN TYPE irregular; irregular EXTERIOR FABRIC(S) textured stucco STRUCTURAL SYSTEM(S) concrete block PORCHES N, open terrace,wrought iron railing, access S 942 = = FOUNDATION: concrete block 942= = ROOF TYPE: gable 942 = = SECONDARY ROOF STRUCTURE(S): f N l E t to bar ;ter, i el tile; E side, 942 = = a, CHIMNEY LOCATION: S, interior, rear slope 942 = = WINDOW TYPE: wood casement 942- = CHIMNEY: CBS bellcote with gothic point 882_ = ROOF SURFACING: barrel tile 882 = _ ORNAMENT EXTERIOR: cast masonry 882= = NO. OF CHIMNEYS 1 952 = = NO. OF STORIES 1 950 =._ NO. OF DORMERS none 954 = = Map Reference (incl. scale & date) Shore_s_Village Plat.J980 Latitude and Longitude: O Site Size (Approx. Acreage of Property): LT1 LOCATION SKETCH OR � AP 1 N . E g3`�•5r' IP 0/1 N. g 2n4 E 91 T 12 1/ Contact Print Sr. 0 N UTM Coordinates: Tone �Tng N fEiing iiWiEJIJ -J V i e r 872 = = 874 = = 964 = = 966 = 854 = = 856 = = 809 = = 800 = = 833 = = 890 = = Photographic Records Numbers _85N104HG10I85N104HG11 860= = STATE OF FLORIDA DEr,RTMENT OF STATE - Division of Archives, History and Records Manabement DS HSP -3E 9 -74 CONTINUATION SHEET Garage added 1929 Wash room added 1936 CBS storage room added 1938 New roof 1969 ' Aluminum awning windows in rear 1969 . MSHPB USE ONLY Site No. site Name 152 NE 93rd Street Miami Shores, FL Physical Description: Structure is a one -story Mediterranean Revival residence. Its prominent feature is a 11/2 story entry tower on the NE. The entry has been enclosed with an elliptical arched window and the front door relocated to the W. A large span of French doors lead to the open terrace on the front (N) facade. Doors have a large, elongated triangular transom with a cast masonry lion's head at the point of the triangle. Curvilinear parapets are on the E side of house and W side of porte cochere, which is attached to the W. The entry tower has a hip roof with decorated frieze. Structure reflects an unusual amount of detailing for a home of its size. There is a detached garage and work room in the rear (S). a a a 0 I)- :l _ • it J I '• IrACI 0111 i, 9 2 .0; aa1� as ®mma�eaae® 111111®®m AIH11011 ��ea ®111111411 © ® ®® eml,�mmmmmd ®mmmm� 0115911111 111111 „ ing ELM a „ 2 �5 N4 9 7 N. N. W • , !. 6 5 4 3 2 1 nue .�, s 111111 ®L eoo1a© ©11 000vaooa mmamlig � ., mmm 5 / V gmea �11od110911 4 r... r �1oeo�aaeo� 1-ii dim ���m111�'�1 g ���d0! 4 O�°�� aidgi ° 1m� "• NWT mom .� rJ w. 99 SCR 8011Da0'1 Es Am 111 NOW= 5 9 = 5-r. MOON Eil17 'e 1 © e BI 1,,.N. _ Ilia 11 4 T ;H w. 93 M ,.1 m100oaa011 1 to �Qm Z D . o 8•'" " 107 . 0 S�. 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CHURCH SO 5 • 8 , - 0111 ,0 L A 1 1 111 ;I t 11111901911 osoriss NE MR MAN lio'4 rid .11,0111111 1�11' 11115jIIIN 111111411111 111111 = POS a dm ` i111 et.0a m 11a�!m 1 611 • W 11 !Or Car 11 itall nie ACP iglus Engin MI JO 14 1 1'1 1 0 sr =LAMM dIAM1 SHORE El afErIARY SCHOOL pvi .00.-11-26-5m Vorm Architect Purpose of building (by floors) STATE, OF FLORIDA CITY OF MIAMI FLORIDA OFFICE OF BUILDING INSPECTOR APPLICATION FOR BUILDING PERMIT (A copy of this Application, together with one copy af plans and specifications, must be kept at building during progresi of the work) Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and con- formity with the Building Ordinance of the City of Miami, Florida which said Ordinance was approved July 7th, 1919. All provisions of the Laws of the State of Florida, all ordinances of the City of Miami, and all rules and regulations of the Building Department of the City of Miami, shall be complied with, whether herein speci- fied or not. 192 Date �,' " , Owner's Name and Address ` � Street , fi c, ` / '' No - Name and address of contractor or builder Location and legal description of lot to be built on: Lot Block s/ Subdivision Street and Number where work is to be done and for no other purpose. New Building_ Additior Repair Remodeling Number of Stories Estimated cost of Improvements (not including furnishings) S ' Type of Construction Roof covering Foundatio- Footing Number of persons to be accommodated (maximum) per floor Size of building lot Distance :'rom next nearest adjoining building (from all sides except street) Heating system, if any (kind) (yes or no) Phunbing (yes or no) F.lec. (yes or no) Elevators: passenger freight manufacturer :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 build- ing and its construction may be sent to Notary Public. My Commission Expires This space represents the lot; make outline of ground plan showing distance of building from all lot lines. (Signed) COUNTY OF DADE. (SS. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac- knowledgments, personally appeared 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 building, that he has carefully •e ad the foregoing application, and that he did sign the same and that all facts therein by him stated are true. Bead, sworn to and subscribed before me, (Signed)— TO BE FILLED L I3Y BUILDING INSPECTOR Permit No._ _" issued upon above Application__ , 192 Cl Disapproved , 192- - Ileasons:_ (Signed)_ Building inspector. Application is hereby made for the approval of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in comp- liance and conformation with the Building Ordinance of the Miami Shores Village, Flor::da, 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 Department of ;MIiami Shores Village, shall, be complied with, whetherspecified or not. ARCHITECT CONTRACTOR LOT BLK SUBDIVISION STREET # NEW ADDITION ,��, REPAIRS ;! NUMBER OF STORIES ROOF COST(exc?uding Architect's fee, Landscaping and Garage$ Building to be used for and no other use. I hereby submit all the plans and specifications for said building. STATE OF FLORIDA) COUNTY OF DADE ) Before;rne, the undersigned authority, a notary public; duly authorized to administer of the and take acknowledgment, personally appeared to me well known, and who, being by me f:r$t duly sworn, upon oath deposes and says that he is the builder'of the above described const ruction, that he has carefull;, vead the foregoing application, and that he did sign the same, end that facts stated by him are true. Read, Sworn to and Subscribed before me, Notary Public (Signed) My Commission expires Cubic Feet Cubic feet required in this Block Planning Board Chairman Nembcr Member Si , 2 etary Building Inspector i Peomit No.' Issued to Permit Electrical 1?o. Piermit Plumbing BUILOIN G _ PERMIT - RECORD MIAMI SHORES VILLAGE FLORIDA APPLICATION Signed DATE Datn /4 BUILDING ELECTRICAL PLUMBING Owner of Building PERMIT N9 3 Work to be performed under this Permit Architect Contractor or Builder Legal Lot Bl. Description Address of Building MIAMI SHORES VILLAGE, FLORIDA DATE ° 194 -r` Contractor's License No. 8 vision Value of Project Amt. of Permit ,a> �i;i �tL�• This permit is granted to the contractor or builder named above eo construc. the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shov'n on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed By ,! INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with aji,,grdinances and egptag P s pertaining thereto and in strict conformity with the plans, drawings, statement; or specifications submitted to the proper audifdtities of Miami •e ltbfe3'�' MS ge. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT . APPLICATION F'OR ELECTRICAL PERMIT Permit No.____________________ Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work. Owner's Name and Address Registered Architect and /or Engineer Employing Electrician's Name �___�_________� No. Street_ and Legal Description Lot___________________________ Block Subdivision __________________________________ Street and Number .where work is to be performed —No ___W_ _ _� Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition. Repairs Service Overhead Size Feeders Conduit.__________ plain Sw. Underground Type of Installation— Conduit Tubing ____ B.X. i,.________ Metal Moulding Amount of Permit $ ss. (Signed) Electrical Inspector. 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 com- plied 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 under signed agrees to employ only suck sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) No.__.______________ __ _______ Street___ No. of Stories Amps. Main Fuses____________________Amps. Master Electrican. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath leposes 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. My Commission Expires Notary Public. State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO.LAMPS REFRIG. OUTLET IRON OUTLE" RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL. CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT . APPLICATION F'OR ELECTRICAL PERMIT Permit No.____________________ Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work. Owner's Name and Address Registered Architect and /or Engineer Employing Electrician's Name �___�_________� No. Street_ and Legal Description Lot___________________________ Block Subdivision __________________________________ Street and Number .where work is to be performed —No ___W_ _ _� Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition. Repairs Service Overhead Size Feeders Conduit.__________ plain Sw. Underground Type of Installation— Conduit Tubing ____ B.X. i,.________ Metal Moulding Amount of Permit $ ss. (Signed) Electrical Inspector. 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 com- plied 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 under signed agrees to employ only suck sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) No.__.______________ __ _______ Street___ No. of Stories Amps. Main Fuses____________________Amps. Master Electrican. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath leposes 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. My Commission Expires Notary Public. State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship.