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460 NE 93 St (4)MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT 3 APPLICATION FOR ELECTRICAL PERMIT G �J Permit No 2 3 �r Date. e) L , 0 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. u/ Owner's Name and Address /7/..L./4 1,2'CA . 0.Q No 7 v a N 81 Street Registered Architect and /or Engineer Employing ElectriciaA's Name 6 2--drGrX./ .(4 1- 7'1V' Qy d.S No Location and Legal Description Lot Block Subdivision Street 2.2 . Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) "60 New Building Remodeling Addition Repairs IP Amount of Permit $ (Signed) STATE OF FLORIDA, l COUNTY OF DADE. I ..Vci(8Ata ,$s dic d - 71, 204 A/r'.,. (Signed).. 2 Ai treet 121 a,1, No. of Stories Overhead JJ ,,//��� ( 4 Service Underground Size Feeders... /s Main Sw .2.° Q Amps Main ewes d0 Amps Type of Installation— Conduit ......... Tubing B.X.L .Metal Moulding ctrical Inspleefor. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob1i ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida rmanent 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared /4- .{' .. /.. 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, and he has carefully read the foregoing appliatt n,. and that he did sign the d that all facts therein by him state ET true NOTARY PUBLIC • SATE OX FLORIDA At LARGE MY COMMISSION EXPIRES SEPT. 11, 1978 BONDED' PiRU- GENERAL•INS,UNDERWRITEI My Commission Expires 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. e Notary Public, State of Florida Muter Elect SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P•T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER H W. H EAT. CONN. SPACE H STRIP H TOTAL CONTR. LIST CHECK ENT. 8W. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 0.1 HP MOTORS 1.S HP N EON TRANS. RADIO TOTAL CLST LIsT d 2 0 / . CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT 3 APPLICATION FOR ELECTRICAL PERMIT G �J Permit No 2 3 �r Date. e) L , 0 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. u/ Owner's Name and Address /7/..L./4 1,2'CA . 0.Q No 7 v a N 81 Street Registered Architect and /or Engineer Employing ElectriciaA's Name 6 2--drGrX./ .(4 1- 7'1V' Qy d.S No Location and Legal Description Lot Block Subdivision Street 2.2 . Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) "60 New Building Remodeling Addition Repairs IP Amount of Permit $ (Signed) STATE OF FLORIDA, l COUNTY OF DADE. I ..Vci(8Ata ,$s dic d - 71, 204 A/r'.,. (Signed).. 2 Ai treet 121 a,1, No. of Stories Overhead JJ ,,//��� ( 4 Service Underground Size Feeders... /s Main Sw .2.° Q Amps Main ewes d0 Amps Type of Installation— Conduit ......... Tubing B.X.L .Metal Moulding ctrical Inspleefor. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob1i ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida rmanent 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared /4- .{' .. /.. 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, and he has carefully read the foregoing appliatt n,. and that he did sign the d that all facts therein by him state ET true NOTARY PUBLIC • SATE OX FLORIDA At LARGE MY COMMISSION EXPIRES SEPT. 11, 1978 BONDED' PiRU- GENERAL•INS,UNDERWRITEI My Commission Expires 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. e Notary Public, State of Florida Muter Elect BUILDING ELECTRICAL PLUMBING tt PERMIT N? 4089 Work to be performed under this Permit Owner of Building MIAMI SHORES VILLAGE, FLORIDA Architect Contractor or Builder Legal Lot Bl. Description Address of Building 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- cation 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 that he assumes respon- sibility for work done by his agents, servants or employees. Subdi- vision Value of Project DATE 194— Contractor's License No Amt. of Permit 1 Signed • 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 regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner of 1 Building J • t Architect Contractor or Builder Legal Lot Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT Work to be performed under this Permit B1 N° 5538 Subdi- vision Value of Project $— DATE 7- 2 'I- 6 ' V Contractor's License No. BY AUTHORITY Ra 19 Amount of 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 applica- tion 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 that he assumes respon- sibility for work done by his agents, servants or employees. Signed• t f x -' r 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 regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ao cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. ABBOT 4S PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER l e 3t. AdiaA■, 1940 / I----t'- 1/1 7/10 MA.)- - ,/ (1 .....0/ V 1941 1941 /Q ' � C ! 0 2 1 - /2 1-1 .23/3 / ^Y�4� JS3y VI TIC j ) W° / 6,-iefi i i 1943 CL -/- ' * .. /o Q o z X47- Va ti -43 tJ It 1944 7 '771. / n .14. . d i r. lii�: ,�c .. �r 1945 , 1 � / , G 1 - /4 - CS 2D, d j 9 ) (/ ' U ')` T ' '� �� �� ���� �� e fi(��irl, Ofr; • �';:// 02� ���� l/� -", "?.Z -4 1946 1947 /0 1 k /.). 10 o / - 21 - h 11.--74. �� • C.(. -Li e 7'117 ,LJJZ�` rr y 1948 1? -00 / ,. -v -t/ " ,\ ti / Z -/2- V ) /D3 %(r it 41. 1949 ,, jf• 31 79 / / S° 'I it / 1 - 34 - /- !D S /4 4 7) -- /J / q s7 // 1950 // LOCATION 460 N. 1:;. 93rd L>treet v f;;, _e TAX RECORD 460 N. E. 93rd St. I. . yN.L4.11.)4 /; year annual tax period used amount paid date paid receipt # /400iwitz (: ( _ (/' ' - 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. 830= = Survey Date 8506 820 = = Site Name 460 NE 93 St. , Miami Shores, F1 33138 905= = Address of Site: Instruction for locating on S side of NE 93 St. between NE 4 Ave. F. NE 5 Ave. 813= = Location: Miami Shores Sec 2 50 W1 /2 3.E1/2 5- 4 subdivision name block no. 808= = County: Dade Owner of Site: Name: Derrer, William R. Address: 460 NE 93 St., Miami Shorps, Fl - i'l1 � R g02 = 848= = Recording Date 832= = Type of Ownership private Recorder: Name & Title Newton, Margo, Chairman, & Stofik, Marty Address MSHPB 818 = = Original UsePrivate resid. 838= = Condition of Site: Integrity of Site: ' Check One ' Check One or More present Use Private res id.850 = = ❑Excellent 863= = 8 Altered 858= = Dates: Beginning 1932 844 = = 0 Good 863= = L Unaltered 858= = Culture /Phase American 840= ❑Fair 863= Original Site 858= = Period 20th Century 845= = ❑ Deteriorated 863= = ❑ Restored( )(Date: )( )858= = ❑ Moved( ) (Date: )( )858= = r NR Classification Category R ui1riinJ 916= Threats to Site: none Check One or More ❑ Zoning( )( )( )878= = ❑ Transportation( )( )( )878= = ❑ Development ( )( )( )878_ ❑ Fill( )( )( )878= = ❑ Deterioration( N )( )878= = ❑ Dredge( )( )( )878= = - --- ❑ Borrowing( )( )( )878= _ ❑ Other (See Remarks Below): 878 = = Areas of Significance. Architecture 910 = = Significance: Structure is a one -story residence showing the use of Spanish Colonial Revival architecture in the informal style. The architect, Robert Law Weed, was one of the architects responsible for setting the theme of the original Shoreland Company's development of Miami Shores. The home is in scale and character with the surrounding neighborhood. • 911 = = Township Range Section 812 = = 53S 42E 6 ARCHITECT Weed, Robert Law (Miami, F1) 872= = BUILDER --- 874= = STYLE AND /OR PERIOD Spanish Colonial Revival 964 = = PLAN TYPE irregular; irregular 966= = EXTERIOR FABRIC(S) smooth textured stucco 854 = = STRUCTURAL SYSTEM(S) concrete block 856 = _ PORCHES N -open loggia,brick pillars,access N 942 = = FOUNDATION: concrete block 942= = ROOF TYPE: intersecting_ gable 942= _ SECONDARY ROOF STRUCTURE(S) cross gable , 'barrel tile; solar tail = = CHIMNEY LOCATION: center, ridge 942 = WINDOW TYPE: jalousie 942 = = CHIMNEY: CBS 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) . Mi ami Shores Li11 age Pat- 1980 Latitude and Longitude: O Ir Site Size (Approx. Acreage of Property): LT1 LOCATIONSKETCH OR MAP N z Photographic Records Numbers Contact Print 60 N� •3sr MOEN Sr k-6o q3 C 85N104HG14 - 860= = -*m ` UTM Coordinates: — Zone , - EaiTTng North,np 809 = 800 = _• 833 = = 890 = = .TATE OF FLORIDA DEPARTMENT OF STATE Division of Archives, History are Records Management DS-HSP -3E 9.74 CONTINUATION SHEET Site No. Slte Name 460 NE 93rd Street Miami Shores, FL 33138 Physical Description: Structure is an informal Spanish Colonial Revival one -story home. Its section telescope from .E to W with a cross section on E. An open loggia, supported by brick pillars, fronts the facade (N) on the W. Ventilators.are cast cement grills. Simple shutters are decorative only. 'MSHPB'USE ONLY Remodeled, 1937 (addition) Alterations 1936 by R.L. 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N4.3 P Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date 7 �_ r � 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 s _1l ' L_LYY1 k7__L No.___ _ ..... _..___ Street Registered Architect and /or Engineer _ _______ Employing Plumber's Name_.N :1.2+ t� O _k: r _' •'1 L_ Street_ • r. Location and Legal Description Lot___J. __.______ Block_ t� Subdivision - _____.______._....... q n Street and Number where work is to be performed —No �. (` %i Street_ State work to be performed and purpose of building (By Floors) New Building __ Remodeling ____ ____ Addition________. ..... Repairs No. of Stories.. ....................... Size Septic Tank - -- Feet of Drain Tile Nature of Water Supply: City —Well . Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. Type of Tank Dist. Feet of Tank or Drain Field from Well —__. Size of Soakage Pit (Signed) _ Capacity Gals Plumbing Ins. ctor. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Penman - Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo ed 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 sub- contractors, on work, jo; be performed under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida 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 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. 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. CLOSETS BATH TUBS SHOWER. LAVA- Toms SINKS SLOP SINKB LAUNDRY Toes URINALS CATCH BASIN FLOOR DRAIN DRINKING FDUNT•N6 pn , , , ��� / TOTAL FIXTURES CONTR. LIET e �� 1 / / CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHICK / P Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date 7 �_ r � 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 s _1l ' L_LYY1 k7__L No.___ _ ..... _..___ Street Registered Architect and /or Engineer _ _______ Employing Plumber's Name_.N :1.2+ t� O _k: r _' •'1 L_ Street_ • r. Location and Legal Description Lot___J. __.______ Block_ t� Subdivision - _____.______._....... q n Street and Number where work is to be performed —No �. (` %i Street_ State work to be performed and purpose of building (By Floors) New Building __ Remodeling ____ ____ Addition________. ..... Repairs No. of Stories.. ....................... Size Septic Tank - -- Feet of Drain Tile Nature of Water Supply: City —Well . Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. Type of Tank Dist. Feet of Tank or Drain Field from Well —__. Size of Soakage Pit (Signed) _ Capacity Gals Plumbing Ins. ctor. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Penman - Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo ed 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 sub- contractors, on work, jo; be performed under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida 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 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. 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. (v/2 Name and address of licensed contractor Location and legal description of lot to be built on: Lot /P',` 6 /7 Block f� Street and Number where work is to be done State work to be done and purpose of building (by floors) Permit No Date Disapproved =-%bate (Signed) MIAMI SHORES VILLAGE 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. e-----. Date � 'e_ ' , 19 ‘' ° �' Ce /�D /i /4-, e e .. ✓ ti # No 4/6 Street /y .� y 3 2u ` Ownei s Name and Address._ { Registered Architect and /or Engineer e %9w' A ,P, Ce, if'®! / o ; e ✓, Subdivision e_ Member Member Council Approved Date iv c? -mod and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To he constructed of Kind of foundation Roof Coverin Estimated Total cost of improvements $ 1 - ' Amount of Permit $ - kr' 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 Building nspector / y Commission Expires PLAN G BOARD DATE Chairman Member Member ; Member 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 ender 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 subcontractors, on work to be performed under this permit as are licensed by Miami Shores Village • Remarks (Signed) ' e. 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 application, and that he did sign the same, and that all facts therein by him stated are true. O ° � Read, Sworn to and Subscribed before me. Notary Public, State of Florida 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. M i m .-9n3urance Agency, inc. H. H. Woo MALL. JR.. PRES. INSURANCE IN ALL ITS BRANCHES 682 N . E . 1 2 4 STREET NORTH MIAMI. F L O R I D A TELEPHONE P L 4.0615 License Department T ?11ami Shores Village Florida ATTY.: 1 .r. Bradford Gentlemen: As per our telephone conversation with you last Creek, you will find attached hereto Certificate of Jorkm.en's Cerpensa- tion, Public Liability and Property Damage insur7rce issued to the above providing limits as indicated. Trusting same will be found entirely in order, we remain Cordially yours, NLma TNSURIT NCY, INC. "I/7/ /6 r / n _ D encl. CC Fr. Richard Kohlmeier, Jr. 10840 Y. L. 3rd Avenue Miami, Florida December 9th, 1959 RE: Richard Kohlmeier Jr. KIND OF POLICY POLICY NO. EFFECTIVE DATE PERIOD LIMITS Workmen's Compensation BYC53 97 71 12 -4 -59 1 year Statutory Public Liability Not Automobile BL C17 67 91 12.4 -59 1 year One Person $ 50,000. One Accident $ 100,000. Contingent Liability Not Automobile One Person $ One Accident $ Property Damage Not Automobile BHC17 67 91 12 -4 -59 1 year One Accident $ 5,000. Total Limit $ 25 Automobile Bodily Injury Liability One Person $ One Accident $ Automobile Property Damage Liability One Accident $ This is to Certify, that policies in the name of 10840 N. E. 3rd Avenue, (STREET AND NUMBER) are in force at the date hereof, as follows: and cover, in accordance with the policy terms, at 455 N. H. 93rd Street, Miami Shores and elsewhere in the State of .Florida Certificate issued to TIL flI SHORES VILLAGE at (STREET AND NUMBER) Miami Shores, Dated this 9th day of December GU 6562a ( Ed. l - 55) UNIFORM PRINTING & SUPPLY DIV. CERTIFICATE OF INSURANCE ( Short Form) RICHERD KOHU'ILIDR, JR. (NAME OF INSURED) Miami, (CITY OR TOWN) BOS .T.I1'....INSUIILINCE...COMP NY (INSURANCE COMPANY) Florida Dade County, Florida (CITY OR TOWN) (STATE) (STATE) In the event of any material change in or cancelation of said policies the company designated below will notify the party to whom this certificate is issued of such change or cancelation. , 19 59 PZIAI1I I A By Authorized Representative MIAMI SHORES VILLAGE 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.. �, / Registered Architect and /or Engineer Name and address of licensed contractor State work to be. done and purpose of building (by floors) Remarks STATE OF FLORIDA, COUNTY OF DADE. j ss Permit No Disapproved Date fi ( Signed) ing Inspector /d 4 /i 2 1 ' C,,oay.k .t Location and legal description of lot to be built on: Lot / Sh d Block ® Subdivision Street and Number where work is to be done 5 /t cr /14. New Building Remodeling Addition To bt constructed of �� Kind of foundation � R- 4 ac. Estimated Total cost of improvements $ C." f ? 'Lone cubage required - sr Distance to next nearest building 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 Date...J L - 12 c'.c p'62 i. V' k?. / Date e , 19 ' 5 Street../ye.,:' C-s O�Vli /(c and for no Repairs No. of Stories de e, Roof Covering Amount of Permit $ 6 ' � c, Flan Cubage_.. _4 }_ ' /, r Size of Building Lot 2 � /.q 7 The undersigned applicant for this building pennit 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Read, Sworn to and Subscribed before me. other purpose. 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. 7Jfr Notary Public, State of Florida 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 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. f - O 2 fyz 3 5 ;30 i 70 I C' nq 7 7 /) /fie / STATE OF FLORIDA) SS COUNTY OF DADE ) of Dade a d State o orida provisions of Ordinance No. Section B -368 of Ordinance desires to build a ` of And Further this Deponent says not: A F F I D A V I T :mod of the Village of Miami Shores, County , being duly sworn, doth depose and say, that under the 185, dated June 15, 1948, amending paragraph (d) of o. 97 of the Building Code of Miami Shores Village, he - on Lot 3�!i Block � Subdivisii, that he is the owner of said property and will be the owner of said ��_� _ _ , that he will do the work personally, and 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 made to carry the necessary Workmen's Compensation, Public Liability and Property Damage Insurance. ,o j 7. File with the Building Inspector as the job progresses certificates showing the payment required by the Federal Social Security Act to the State of Florida or the United States of America. 8. Assume the responsibility of not employing other than properly licensed contractors by Miami Shores Village for any part or portion of the work. 9. Not 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 herin provided, is limited to but cne o /:Tner- builder permit each 2 years, and where an owner-builder has once exercized the privilege herein conferred no second applica- tion for owner - builder permit shall be granted in less than 2 years, unless the applicant is qualified as a licensed General Contractor under the applicable Ordinances of said Village. SUBSCRIBED AND SWORN TO BEFORE ME this 3 day of A.D., 195 '. NOTARY PUBLIC Notary Public, St2 of FIcrid^ at large My cornii6gion ,,; NI ay 20, 1963a i, hit V , It • to 9 8 7 G lT" 5 4. 3 50 2 54.1 L2 Lot No - Ll Subdi•isi ^n MAXI MEW SECTION Mt8 .2 Plat Book 10 Public r.cords of for c / 454. C- N. I. iUEDIA Rog Lngia..r No. 3463 Roy. SURVEYOR No 7l STATE OF FLORIDA IDT 18 & TSS WWT 25 1srT 01 118 N. W. 85th Street Miami 47, Florida T•I.phoa. PL $ -1368 NOTES 1P — Iron pip. U — iron lour 5 3 rd EP — Else. polo •wk — sid•walk R — •aoptil t14kt 4— ca.3ttt .. utc at pugs DADE LOCATION S.et:on o - 53 -1 KAM x, 1111. ACME= 20 y 135 a look 5 MR IDEIMILLIER 10840 I. Z. 3rd . AVE. MING,'14. PL 4 -2745 37 warn FLORIDA 1 h.r.by osritfy; That th. attached SURVEY of the alorest.atien d prop.rty. is true and correct, to the best of ray knowl.dq• and b.k.f, as t.c ntly sur- ♦eyod aad platt.d under ay dir.ctton and supety- •lea; also, that these are no .ocrJachatents, uni.as shows th.r.on 5 V (L V E-'( c s.. t.a r No tP f Is i L Cj ?O BI r- r r V ►J. E_ , ° ) 4" 5' A. .2 501 tI JT• o C. A. T t o v MA,. b 'A.A... 1• . too Ct. ►J E , •S s. 45T. j P '.3 5r 4% t_ t c s. o! ( J I T T n Wc Of ht'I1 THIS LICENSE MUST BE DISPLAYED IN A CONSPICUOUS PLACE A PE1.QALTY IS IMPOSED FOR FAILURE TO KEEP THIS LICENSE EXHIBITED AT YOUR ESTABLISHMENT OR PLACE OF BUSINESS MSV /1958 Village THIS LICENSE EXPIRES *When job is complete License N° 3869 In consideration of the sum of Twenty Five and No/100 Dollars ($ 25 •° Paid to Miami Shores Village, Dade County, State of Florida, R. W. *ohlmeier - 10840 N. E. 108th St. is hereby licensed to engage in or operate the business of Owner - Builder MIAMI SHORES VILLAG RIDA Date Issued nee. 4, 1939 By . "� THIS LICENSE NOT 'TRANSFERABLE 4NITHOUT THE ' PPROVAL OF THE VILLAGE MANGER. APC 6 143:1.'_' APPLICATION FOR CER'I 1K ICATE OF RE -OCCUP A1NCY to re- occupy the single family residence known as : (address) 1 {55/fzr �3 Legal Description: Lot: Block PB & PG: I hereby certify that I understand that the zoning of the property is for single - family residential use and that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re -Occupancy that may be issued by Miami Shores Village, certifies only that the referenced property is being used for single - family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on such property. } Applicant ` �� c ��� Date :.U 2, 1 q Print Name C R i z, E A/2x CC-.5 *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** For purposes of conducting the inspection required by Section 902 of the Miami Shores Land Development and Zoning Code, please contact Contact Name: Cam, A/0 0 5 Telephone: 75 - 5582_ Buyer Seller ✓` Realtor Company Name Application Fee (S Inspected by Comments: d: Cash , ,TO Check No. PAGE I OF 2 , ldiiami Shores, Florida. , hereby apply for a certificate Approved f/ Denied Date /2.23 �$ CER'iU'ICATE OF RE- OCCUPANCY On behalf of vfiami Shores Village, Florida, the undersigned certifies that the property described in the above application has been inspected for purposes of re-occupancy pursuant to Sections 901 and 902 of the yfiami Shores Land Development and Zoning Code and that such property may be re -occupied by the above applicant for single- family residential purposes. THIS CERIII'ICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENT CODE PERTAINING SOT ]T AY TO THE REQUIREMENT THAT EACH ONE- FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE -FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS CERI HCATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO TEE CONDITION OF fl±E DWELLING OR OTHER STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION, AND INTERESTED PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF ' fflE PREMISES IN ORDER TO DETERMINE THE CONDITION, THEREOF. PAGE 2 OF 2