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461 NE 93 St (5)STATE OF FLORIDA, ss• COUNTY OF DADE. 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 regula- tions of the Building Division of Miami Shores Village shall be complied with, whether herein sfied or not. A copy of approved plans and specifications must be kept at b ding during progress of the work. Da�✓ C 19_2`" 7r Owner's Name and Address C21/401 No 4_1 S treet %L - y /` y Permit No. _ Date Disapproved — _ __ Date (Signed) i • • ► MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Registered Architect and /or E gineer r Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block_ Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) and for no other purpose. New Building_____ Remodeling____________ Addition______ ___— __ epairs No. of To be constructed of__________ Kind of foundation__ e _ __Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required Plan Cubage Distance to next nearest building ‘,1,f ,. i Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compile General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from 1 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 ' spection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such su ntractors, on work to be 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 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 be has carefully 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. Building Inspector My Commission Expires PLANNING ::OARD DATE Notary Public, State of Florida Chairman 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. MIAMI S H t7 RES 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 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 regula- tions of the Building Division of Miami Shores Village shall be complied with, whether herein spefified or not. A copy of approved plans and specifications must be kept at building during progress of the work. r.- 4 Date__— / _ _ �� ____ 19 ¢� �° Owner's Name and Address – ! No. — trier_ 5 ) 7 ' Registered Architect and /or Engineer Zone cubage required Name and address of licensed contractor Locatio and legal description of lot to be built on: Lot___ —_ Block — ________ Subdivision Street and Number where work is to be done 4 State work to be done and purpose of building (by floors) – – – -- -- — — — - -- — — - - may — - - -- -- -- - -- — — – – — — -- —and for no other purpose. New Building ___ _______ _________ Remodeling_ Addition Repairs______ No. of Stories__ _ —/ __ To be constructed of _________ Kind of rr foundation � — ___ ______— ___— _______ —_____ Roof Covering_ Estimated Total cost of improvements $ __Amount of Permit $ —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 specificatiq ..fpr said buildin All notices with reference to the building and its construction may r / be sent to t eJ 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 subcontractors, on work to be performed under this permit, as are Licensed by Miami Shores Village. Remarks STATE OF FLORIDA, COUNTY OF DADE. Before me, th u ign authorit appeared therein by him stated are tzu . Permit No. f –''!-- —�, Date Disapproved _____ Date (Signed) _—_— c, duly authorized to administer oaths and take acknowledgments, personally (Signed) r Read, Sworn t \- L 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 tead the foregoing application, and that he did sign the same, and that all facts Notary Public, Building Inspector My Commission Expires (over) to me well known, 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. LIST OF CONTRACTORS, SUB - CONTRACTORS, "ETC. REQUIRING OCCUPATIONAL LICENSES MIAMI SHORES VILLAGE 1 General Building Contractor. 2. Plumbing, Heating, Ventilating, Air Conditioning and Gas Fitting. 3. Electrical. 4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators. 5. Excavating, grading, filling and Landscaping. 6. Moving or wrecking. 7. Septic Tank and Drain Field. 8. Brick, Stone, Tile, Cement Block, Concrete and Gypsum. 9. Carpentry, Millwork, Awning and Shutters. 10. Cement, Lime, Plastering, Stucco, Lathing and Cast Stone. 11. Decorating (interior and exterior) , Painting, Waterproofing, Damp- Proofing and Paper- hanging. 12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring not otherwise specified. 13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors. 14. Roofing, Sheetmetal and Skylights. 15. * Solar Water Systems. 16. Well drillers. : 17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc. 18.. Structural and Reinforcing Iron and Steel. 19. Tile, Terrazzo, Marble; Granite and Cut Stone. 20. Electric Fixtures. . 21. Illuminated Signs. 22. Bridge, Bulk- heading, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga- tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work. 23. Every person, firm, co- partnership, Corporation, Association or other organization engaged in the bus- iness of supplying, furnishing or delivering building materials for any construction project within the Village Limits and not having a regularly established and licensed place of business in the Village. ! i ; Iu ;loo ;I ;t ;fie ► ;r te �! I �!••...., I 1 /.•'...,,l f,.....,��,....,,.1 •1 1 / 1 •• ...,,� I ,, ... .,� 1 ,. ... ,, tl ,. 1 / ,. ... ,, tl ,.....,t l ,....., !• ....,, t ,,. ,,..... .• ., ,...•, r .. ,. !.. • e4 Issu _194/ Amount No. Houses Cam' r BUILDER'S BOND .4 KNOW KNOW ALL MEN BY THESE PRESENTS, that I, Address ' • in consideration of the issuance to me by Miami Shores Village, Florida, of a permit or permits to construct or repair a building or buildings at the following addresses: xc� s4 :0� ic$ do hereby deposit with Miami Shores Village, Florida, the sum of .5 , and I agree with said Village that, when such construction shall have . been completed by me within the meaning of the ordinances of said Village, I will clear all premises and repair any Village property damaged by me, • 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 constructi p within the meaning of such ordinances, the Village may clear and repair the same and pay the costs of such clearance and 7 . repairs out of the aforesaid, %V , and return the remainder to me; and that, if I shall clear and repair said property immediately, as aforesaid, then said a'0 shall be returned to me. �n WITNESS MY HAND and Seal at Miami Shores Village, Florida, this aiami cShores F L O A I D A day of ,!,/", *7, .- it ° ' 7 �' , �t r' 0 • * ( Seal ) s . c ' . •• INSTRUCTIONS TO BUILDER —When above mentioned construction is completed and the premises a# cleared and repaired take this bond to the s Village Building Inspector and obtain his approval, after which Miami Shores Village will refund your mo ey in accordance with the above agreement. -. I VILLAGE BUILDING INSPECTOR'S APPROVAL q I hereby certify that the construction contemplated under this Bond, has been completed and that the builder thereof has caused %C the surrounding premises to be cleared and repaired in as good condition as they were before commencing said construction. s WHEN CLEARED AND REPAIRED BY THE VILLAGE �j , j� i Amount of Bond $ Village Building Inspector jvljpmi Shores Village :1 Cost of clearing and repairs done by Village $ f 1' :•� Balance due Builder $ .-t Cancelled 19 By r" . Ar.+ �' 1C r4r •' C fMruff Mgg.N 1 IM .gli C MA<' 1'• ..'gc ie4.. •'•i'r`• °•'•ct'v'•it`•° •'•ir °•• v.... N° 833 .0 1 4 F.3 tc;) �.y OWNER'S NAME LI,LTON, .112.M - £ PRESENT ADDRESS 461 N. E. 93rd Street Y .`CENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) 461 N... 93rd Street LOT 18 -19 -20 BLOCK 31 SUBDIVISION ivi. S. Sect. 1 GENERAL CONTRACTOR Owner ADDRESS PHONE NO. LICENSE NO. BUILDING PERMIT NO. 7872 1'(] DATE 5/10/1.9 PERMIT FEE $ 5.00 BUILDER'S BOND NO. DATE ZONE PEQIJIREMENTS CU. FT. PLAN CUBE CU. FT. EST. COST $ 1.000.00 DRAWINGS, SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY JDH DATE ']/10JJ9 NEW CONSTRUCTION TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION / REPAIRS DESCR IPTION ( J ALTERATION DESCRIPTION .:xtensian of bedroom and new bathroom X 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. I ISSUED BY I TO BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION DATE FEE TEMPORARY SERVICE $ BEAMS & LINTELS $ SEWER FRAMING SOLAR HEATER S GAS S $ INSPECTIONS FINAL BY RE- INSPECT BY RE- INSPECT BY ROUGHING CLEAN -UP TM BY TDH GAS CONTRACTOR Nu -Way Plumbing; Co. PHONE ERMIT NO. 737 DATE /11/49 FEE $ 3.00 NEW BLDG. ALTERATION ADDITION ][ REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ SEPTIC TANK $ SEWER $ SOLAR HEATER S GAS S $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING 5/12/49 TM BY TDH GAS SEWER SEPTIC TANK SOLAR HEATER FIXTURES CONTRACTOR PHONE PERMIT NO. DATE FEE $ NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ SRANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL. TO POWER CO. FOR SERVICE DATE BY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description 1/ U of Buildin g ____ CONTRACTOR OR BU MIAMI SHORES VILLAGE, FLQ°RIDA PERMIT N? 7872 Work to be performed under this Permit C•f 2 Subdi- vision Value Project DATE. /' /CI- 19 Contractd ''s License No. Amt. of Permit U This permit is granted o the contractor or builder named above to construct the build or to install the equipment or . evice 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. Signed. BY r —, INSPECTOR In co • eration of the issuance to me of this permit I agree to perfo • e work covered hereunder in compliance wi pertaining - to and in strict conformity w e plans, drawings, state . . is or specifications submitted to the proper au 1 In accepting is permit I assume responsib' ' .r all work done by either m self, my agent, servant or employee. By nances awl r�gttis o f Miami S i tl'illage. AUTHORITY PAID BY d i , , ,: ',.. ,, . / y . ) )741 _ ( , , ,,y Et A ANNUAL TAX P PERIOD USED A AMOUNT PAID D DATE PAID N NUMBER / e ) 1 . P 7 ! cha • / /0 1 1 / ;VarMar,_.' ! 1s 43 / , � - y 5�3 S S 3 /Y , �Q o - LOCATION pi61 i�'. . 93rd street /� rl�f .6 0 GARBAGE TAX RECORD �._Daltob by 461 N. E. 93rd St. year annual tax period used amount paid._ date paid deceipt # / 9s/ / a . � 3/- si ci° STATE OF FLORIDA DEPARTMENT OF STATE FLORIDA MASTER SITE FILE D•vlslon of Archives, History and Records Management Site Inventory Form FDAHRM 802.= _ DS HSP•3AAA Rev. 3.79 1009 = _ Site No. Site Name 830= = Survey D to 8506 820= = Address of Site: 461 NE 93 St. , Miami Shores, F1 3313 905— = Instruction for locating on N side of NE 93 St. between NE 4 Ave. & NF. 5 AVe 813 = = Location Miami Shores Sec. 2 5.1 L 25' 19, all 2U 868= _ subdivision name block no. lot no. County Dade 808= = Owner of Site: Name: Hackett, Gile. W. Address: 461 NE 93 St.. Miami Shores, Fl 33138 902 = = Type of Ownership hr; vat e , 848 = = Recording Date • 832= = Recorder: Name & Title: Newton, Margo, Chairman , & Stofik, Marty Address MSHPB Condition of Site: Check One ❑ Excellent 863= = g G ood 863 = = ❑ Fair 863= = ❑ Deteriorated 863 = = ❑ Moved ( ) (Date: )( ) 858 = = NR Classification Category: Building Threats to Site: none Check One or More ❑ Zoning( )( ❑ Development( )( ❑ Deterioration ( )( ❑ Borrowing ( )( ❑ Other (See Remarks Below): Integrity of Site: Original Use Private resicB38= = Significance: Check One or More M Altered }❑ Unaltered LT Original Site ❑ Restored ( ) (Date: 858 = = 858 = = 858 = = )( )858= = Areas of Significance. Architecture )( )878= = ❑ Transportation( )( )878= = ❑ Fill( 1( )( ) 878 =.= ❑ Dredge( )( )( ) 878 = 818= = Present Use private resid.850= = Dates: Beginning 4. 1925 844= Culture /Phase American 840= = Period 20th Century 845= = 878 = = X Structure is an example of the application Of the Mediterranean Revival style to a one -story residence. It was built during the original Shoreland Company's development of Miami Shores. Noteworthy features include the entrance with sidelights. 911 = = 916= = )( )878= = )( ) 878 = = )( ) 878 = = 910= = Township Range Section 812 = = 53S 42E 6 ARCHITECT __ Perry, Lee (Miami F BUILDER Godwin Realty Co. STYLE AND /OR PERIOD Mediterranean Revival PLAN TYPE irregular; irregular EXTERIOR FABRIC(S) smooth textured stucco STRUCTURAL SYSTEM(S) concrete block PORCHES none (entry porch enclosed) 872 = = 874 = = 964 = = 966= = 854 = = 856 = = 942 = = FOUNDATION: concrete block 942= = ROOF TYPE: gable 942 = = SECONDARY ROOF STRUCTURE Sy E massing, flat parapet, tar &grave1g42 = CHIMNEY LOCATION: E endd, exterior 942 = = WINDOW TYPE: jalousie - , 942 = CHIMNEYCBS 882 - _ ROOF SURFACING: barrel tile 882 = = ORNAMENT EXTERIOR: masonry NO. OF CHIMNEYS 1 952 = = NO. OF STORIES VIVO. OF DORMERS (none) Map Reference (incl: scale & date).Miami Shores Village Plat 1980. Latitude and Longitude: Contact Print N. E 94 >n St• r 1) 0 zI 46/ 4/.6'. 0 Site Size (Approx. Acreage of Property):LT1 LOCATION SKETCH OR MAP N UTM Coordinates: Photographic Records Numbers 85N105HG22/85N105HG23 Tone t 1 ng - RoiiFiinp y 21A -4 -itL) 1 882 = = 950 = = 954 = = 809 = = 800 = = . 833 = = 890 = = 860 = = STATE OF FLORIDA DEPARTMENT OF STATE Division of Archives, History and Records Management DS-HSP -3E 9 -74 n CONTINUATION SHEET Site No. Site Name461 NE 93 St. Miami Shores, FL Physical Description: Structure is a one -story home of Mediterranean Revival design. A single -story wing on the E has a flat roof with parapet, the main mass has a gable roof. The entry door has multi -pane. sidelights. Detached single -story garage on rear of property. MSHPB USE ONLY Addition 1944 Addition 1949 New roof 1966 1 rip Et EN vs ICS Imo EN Ift EV i• •.•1, J w . 7 3 ill r MOM mu ®a®amm I ll mB! !VI& amm Mil MOMS o®oP m , JIPm M NI U. , Odin no e �, ! J 2.• • !• 2l 2: N. W s e .2 elD tin amm': ;ON a© ®m 90111 104 Tr. loegmanm anon - pa3 PAK 0 C isliamdiug 6 r- .w comm Ls e N, W. 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Sao 11111.' _ z4 ►� ma , m .:; 11 omm wol arm RE R �av4omoagva ammao mdO P 'r 1 0 4' '• 4 ,,. kil M iODI Hagan ma I LA • ., 1 I 0 J0• Holm 1 ° oDi1 Wow dov�aoam� fi EVEN tid 1111 mu II Ph I d'v�DOed� REA MHO in a er O pmom 'pmt 10 a •• I�! 101 100 9 9 a.. .9 7 96' '~ ss• 9 4 Ame .9 2 1 111 111 lht ' I I 91 • 111110111 1111111111 5 T. a � a mpoov b �9om�i� 1101• MI Ili ARi I°1; 5 -T, 5 T. dm�00o�0�d� mmnana nor 1 , mzma 'IR? 1 T. S T. 0 �mmaosvmvoa� 98 '.. 5 to m aoe9 our umbour ineepani in bids iro b n 93 .•. 5 5 5 T. d �r op4�oa moire m ang T Q TRACT q • •D •f •e ▪ 17 R01C Of l,M,] 101001 I CNURCN 17 ` 71,1.1,1 <1 YO LAKE MOWN MO M JIM re SO' 4040 NE 1 MIME If P. a din: mom rig 0 1111911111 ..simivg NSF 0 AMMO PHI MC: simplo ; HIM Rd ti I 11.0 r to / 1 1161 l'rEq lemur SHORE5 EIEMErfARY BUILDING ELECTRICAL PLUMBING Owner of Building , t P' 1 f r f j CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Work to be perform N? 1533 1 under this Permit . . Subdi- vision DATE 194 Contractor's License No Architect Contractor or Builder Legal Lot Description Address of Value of Amt. of Building ,'/ / / r Project II 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 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 cowered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his age s, servants or employees. Signed , ' .'` ". By ,r PECTOR' 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 th6 plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Tillage. In accepting this permit I assume responbibility for all work done by either myself, my agent, servant or employee. M ' a Y BY RUTH BUILDING PER MI rre filed in this office. This permit k granted upon emus condition es strictly with the plans and tesciftatdoeaa submitted. and is accoudsao r e a p • ncea and zoning laws of Miami Shona VII and wire and aay dine du yioladon of any of said d spedfic ar ' / Owner of Build' Architect and jor Engineer Contractor or Builder Proposed Location This permit is issued to the building above described. as per ap that all facts stated in the application a and compliance with the building regulations of the building laws, o noes or les and regal In consideration of the issuance to plane and apeuilattions thereof heretofore building ordinanv s zoning laws of Dated- A NOTE: A dm* of $1.00 will A re- inspection fee of $I.O0 will be ADDRiaa UMW= WS. ADDRCVS 1 Owner's Name and Address New Building Remodeling Disapproved (Signed) Council Approved Ft J MIAMI SHORES VILLAGE - '. // .2.,4/ rc ,�/ 95 74 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 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 the work. exit() z `t.. E t 9& J ( No Registered Architect and /or Engineer " and address of licensed contractor Location rnd legal description of lot to be built on: �j/ /f J� Lo as 1 q r Block S' Subdivision /'��/Y / ckegs.,& �.� °� , -- - "Street and Number where work is to be done X 4(42 i Ai J S` - 'State work done and purpose of building (by floors), state exterior colors (submit samples) and for no other purpose. Addition To be constructed of Kind of foundation // �� Roof Covering £.- timated Total cost of improvements S Amount of Permit 8 `1 [J / � D 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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 perfor . nder this p.. a ill pos .r cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersig grees to e IVA7,111; uch su',..ntractors, on work to be performed under this permit, as are licensed by Miami Shores Village. \(0 Remarks (Signed) STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared _ �� n 7Q �/ to me well known. ��-++ and who. being by me first duly sworn. upon oath deposes and says th t he is the (`7eitil L C Q l ` ■V�Lc t c.r - e. of the above described construction. that he has carefully read the oregoing application, and that he did sign the same. and that all facts therein by him stated are true. Permit No. %/4 Li O Date Date Read, Sworn to n /a -'3r) -e8 Repairs No. of Stories Supscr -ibed before me. a�L �Li. _> ,e Notar t ° 'lb c; y,, W • rl .r 19 Street // ogre 1" Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Date Disapproved Date NOTE: A charge of 825.00 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 825.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials andior workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby mode for the approval of the detailed statement in me plans and specifications herewith submitted for the build in¢ 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 --- _ _..._... 19.8 Owner's Name and Address h ki IA O No.....�?.T _E Str eet) s Registered Architect and /or Engineer .:,. Name and address of licensed contractor ' r l i" P Ss 0 c , 55 O I `1'Q Location and legal description of lot to be built on: A �-- 3313 Lot Block 11 '' Subdivision q Street and Number where work is to be done WO _ N E _. ..1. 3 ._S ._..__ State work to be done and purpose of budding (by floors).... 10 E U 4JP JTN-l7 (L% (� S -IVA) .__ _..._........and for no other purpose. Ncw Building Remodeling Addition Repairs No. of Stories _ To be constructed of Kind of foundation Roof Covering Estimates Total cost of improvements $ ‘ • r ° 1D Amount of Permit 3. ,..° plan Cubage Size of Building Lot Zone cubage required Distance • to next nearest building Maximum live load to be borne by each floor 1 hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to.. sass ... ......... The undersigned applicant fur 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 Sup m cleent, 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 sucl�sube nsciaq, • • •rk to be performed under this pcnnit, as are licensed by Miami Shores Village. Remarks (Signed) Building Inspector STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated aree true. 'I ti . . �! /�, Permit No..__. _ 1 Date )1•51V0 Read, Sworn to and Subscribed before me. Disapproved Date .._.. Notary Public, State of Florida (Signed) My Commission Expires. ..._._._._ to me well known, PLANNING BOARD DATE Ciiair:nan Member ....... _ ...................... =. _..__...._.................._._ Mcrrsber 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 Pl.rnnir.g Board. A rc•in.pection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship.