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905 NE 92 StOwner's Name and Address — STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI S'HIJRES VILLAGE Registered Architect and /or Engineer___ 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. Name and address of licensed contractor Date Location and legal description of lot to be built on: Lot icit - Block Subdivision • � //:? 4` � a Street and Number where work is to be done , d`` / -2`� �14 � "� e State work to be done and purpose of building (by floors)__ `- - —� �- =� _-__ -/ �'� .:� ^ ,_ _ � , � � -� � . Notary Public, State of Florida , 19 — — and for no other purpose. , New Building __2_<! Remodeling Addition Repairs No. of SStt es To be constructed of ect—i ' Kind o foundation Ste_; "fLz Robf Covering / f Estimated Total cost of improvements `-- ` �� $_ 'c o (x p $ - -- -� — Amount of P ermit Zone cubage required flan Cubage_____ ;?.__:f.9 uired 14 ti 6' _ °- g- Distance to next nearest building L 0 Size of Building Lot ,J$ A d am' Maximum live load to be borne by each floor / I 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, Compiled General Laws of Florida, Permanent Supplement, and has complied with the rovisions 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 subc tractors, on work to be performed under this permit, as are licensed by Miami Shores Village. c , Remarks_ ______ (Si nec `° ` ,, r 99 7 r ' 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. Permit No.___ ___ /7 /i Date _� Read, Sworn to and Subscribed before me. Disapproved __ /Date (Signed) Building Inspector My Commission Expires PLANNIC 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. n— STATE OF FLORIDA) SS COUNTY OF DADEs A F F I D A V I T F. G. Capps of the Village of Miami Shores, County of Dade and State of Florida, being duly sworn, doth depose and say, that under the provisions of Ordinance No. 183, dated June 15, 1918, amend- ing paragraph (d) of Section B -368 of Ordinance No. 97 of the Building Code of Miami Shores Village, he desires to build a single family► residence on Lot "A" Block of Golden Gate Park Add, Cubdivision, that he is the order of said property, and will be tiie owner of said r fd neA , 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 Loard 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 '.7orknen's Compensation, Public Liability and Property Damage Insurance. 7. File with the Building Inspector as the job progresses certi- ficates showing the payment required by the Federal Social Security Act to the State of Florida or the United States of America. 8. Assume the responsibility of not employing other than properly licensed contractors by Liiarai Shores Village for any part or portion of the work. 9. Sot set himself up as a "contractor". 10. Sign an affidavit before commencing work to the effect twat 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 Eiami Shores Village. Such affidavit to be properly notarized upon blanks to be supplies' by the Building Inspector. 11. In order to prevent abuses and subterfuge the right of such owner-builder as herein proiided, is limited to but one owner- builder pen:lit each 2 years, and where an owner- builder has once exercised the privilege herein conferred no second application for owner-builder permit shall be granted in less than 2 years. unless the applicant is qualified as a licen406 General Contractor under the applicable Ordinances of said Village. And Further this Deponent says not: SUBSCRIBED AIM S'. +ORid TO B ,rOR2 ME this 19 . day of NTOTr RY PUBLIC A. D., Residence fir. & Mrs • F. G. Ca pps BA T:ROO] 1 FIXTURE SCYRD' Lavatory: 1-455 19 "X17" reuday Lavator:- 8-130 C.P. SuDply E: Waste . _xture p y0 C.F. JI "F" Trar .r . 1 17 a . r lrai R -1712A C .r. " Su_ r_1ie:, %/ Stc_.. • 8 - 090 C.P. Bars Eath: 2 -9C 5 - euds. Sat' 2 -305 C.F. _ . 3at1- Shower Tr_� 9 -5C C a 7- , Pon - p raste c: overflow; 4 -103 C.z• 1"X :E0" S r .'cu 0 Clcset tr. C' or, IRO0: ' s : :7 • . -1712 C.P. " Stl: 71' ,/ - 7. Clc. e.t . la ._ :e _ .- • 1 E: 1 "::1"" : :e a? • La-r.,.tor;. • 1 -" 17 s.. " � Tr_ R- . ? - h S; i ; % Stoi, rs Shower: :.Fsal Conte' led t : valve s }.c-.'yer r` .e_r eEi or 1 2.a11 joint shower head 2 C.r. 7 S' .:o :e " Drain Close - : et S R- C.:. . fit s . _,1-- w/ Stop. -074 01 ns et 1 ianc,e :'',; • April 13, 1950 C R A I'. E CC. - 5-131 32 "X21" Enameled ;rc.. .,. . . to : : im Sir_ Erfne.ss le c: e t' +, , f.ittir" C rl Oa: Ctr -i :er 0-240 25 "X24" Sin :le Ce -..art °.t Ceran'. ;:.rote e.r_ e ir c:. s co ortinT fra - R0 _ . - tc. °e . -late r :/ sr :in,ir.. � :t} :ras: sto_i'er BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application Ls 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 Vi11Rge 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 Location and legal description of lot to be built on: Lot_______ -_- _— _ - - -_ -- Block Street and Number where work is to be doneL I 3 2 C State work to be done and purpose of building (by floors) MIAMI SHORES VILLAGE 6 W0 , 19 Str I / and for no other purpose. New Building R modeling Ad lion To be constructed of-_C____ Kind q foundati Estimated Total cost of improvements $ Zone cubage required /6 dire' Distance to next nearest building A. 0 , Maximum live load to be borne by each floor Chairman Member Member Council Approved Repairs No. of S es q R Covering ° Amount of Permit $ l e • o Plan Cubage 3 C Size of Building Lot 1?.X• % 540 .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 5988, 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 su tractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks - - - -- — - -- - — - - -- (Sign STATE OF FLORIDA, I COUNTY OF DADE. f SS. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally ap- peared to me well known, and who, by me first duly sworn, upon oath deposes and says that he is the of the above 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. Permit No 922 7 Date .."s 3 Read, Sworn to and Subscribed before me. Disapproved Date s ( Signed) Notary Public, State of Florida My Commission Expires Alb PLANN BOARD DATE Member Member Member • 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 AO ...... 000-. > 0000s .••..e..•.e•.00.oe•eoneonCAI ")^4eeonaeA.14AR ee.t.CLo .. .b.A 1,9, ..... G k.. " .► 1 3 %o. i 'E 13 .x{ : cl°ci cro ctso cicz_____s,v,„ c't 74, � 2254, &- ATAIM OF FIDR1D) - COUNTY Of DADE 1 Atilitatt And Further this Deponent says not NOTARY PUBLIC a. G. Capps at the Village of Mast Shores, County o f Dade and State of Florida, being duly sworn, doth depose and asy, that under the,provisions of Ordinanee ,No. 185. dated Inns 115.1 sm ad. inj paragraph (d) of Section B -368 at Ordinanoe No. 97 at theikaltiag Cade at Miami Shores Village, be desires to build a single f Zy an trot '`' Block of Golden Oats Park *ft. & vision, that he is the owner of said property, and will be the owner or said postslena. 4 that he will do the work ,p. ersonally, and that be will, at such times as are required by the Zoning and Building Direotors- l. File plans and specif icationa and obtain approval of the Planning Board and the Building Inspector. 2. Apply for and secure a Permit. 9. Pay the required fees. 4. Execute the cork in accordance with the provisions of this Code. 5. Apply for inapections. 6. File with the Building Inspector certificates that provision has been made to carry the necessary Vorkaten's Compensation. Public Liability and Property Damage Insurance. 7. File with the Building Inspector as the job progresses certi- ficates showing the payment required by the Federal Social Security Act to the State of Florida or the United States of America. 8. Assume the responsibility of not employing other than properly licensed contractors by Maui Shores Village fur any part or portion of the work. 9. 410 set himself up as a 'contractor'. 10. Sign an affidavit before commencing work to the effect tuat he teas read this Article and will do the work personally and observe all of the requirements of the Building, :slectrical, Plumbing and Zoning Codes of Miami Shores Village. Such affidavit to be properly notarized upon blanks to be supplied by the Building Inspector. 11. In order to prevent abuses and subterfuge the right of such owner- builder as herein provided, is limited to but one owner - builder permit each 2 years, and where an owner- builder has once exercised the privilege herein conferred no second application for owner- builder permit shall be granted in less than 2 years, unless the applicant is q atified as a licensee General Contractor under the applicable Ordinances of said Village. SUBSCRIBED MD SUOBN TO BMX: NE this day of As D.. 19 .