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128 NE 94 St (4)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n Permit No. Name Address < q' Ot Company - Phone # U (v ! 7 c I For Inspector: I ( O Name & Approved 3 Correction Re- Insp'. 'ee ❑ 7-; January 9th, 1964 Mr. Fred Lindquist 360 1:;. E. 159th Street FlorEn Dear Mr. Lindquist: Prior to n fi=a1 inspection and issuance of c Certificate of Occu- pancy on the Jack Moore Reeidence nt 128 We E. 94th Street, the fellowin3 contractors must secure from Miami Shores Village nn Occupational Licenses Dale Doya Paintin Seminole Til© CoDpany Upon the iseuance of Licenses n Certificnte of Occupancy mill be issued cai' mailed to 1-7r, noore and n 050.00 refUnd uill be undo on your Dancer's on 02594 upon submieoion to the Building De- pnrtment. WRB Very truly yours, William R. Bradford, Director of building 8 Waning ITEMS az SUB CONTRACTORS & SUPPLIERS NAME & ADDRESS Al'' IUNT 1. Architectural Fee plans FL.,,,�R, ..,,/ . „_., mL o 111111141■ W ' wa . Asphalt ,lks p drives. etc.') 3. Cabinets - Bath Vanity 4. Cabinets - Kitchen 5. Cabinets - Medicine 6. Cabinets - Unit Closet 7. Cleanin .0-),V"). 8. Clearing Site 9. Concrete - Foundation.Slabs,Beams 'r 10. Concrete - Walks drives etc. , 11. Contractors Fee _ _ 12. Electric Fixtures / ,: ,d 13. Electric Wiring 14. Equipm Rental 15. Excavation 16. Fill for Slab 17. Floors - Finish wood & kitchen 18. Floors - Terrazzo /_,J! ~7 „A • 19. Garage Doors 20. Glass Sliding Doors . 21. Hardware - Finish 22. Hardware - Rough 23. Heating___ 24, Insurance - Liabilit ,come.-bond 25. Labor - Payrol.1 Q.,,,,aiz,, 26o Labor - Contract ' 27. Labor - Contract i 28. Landsca in Fili Grading (D VA. 29. Lath Plaster Stucco f?- 'w' , 1 z r ,,, /1lo, 30. Lumber (A11) y 31. Masonr Labor .. ,'..__ ,0 32. Masonry Materials Block 33. Millwork 34. Miscellaneous 35. Ornamental Iron Work , 36. Oven & Plate - Built -in 37. Overhead 3A0Paintin ✓ 11 Permits Tem orar Power _ice _ / MIER 40. Foundation 41. Plumbin. Com•lete 11 W/.1... , .. / L4...., 42. Pool - Swimmi / 43. Roofin: & Sheet Metal Work 44. Woof Trusses - Prefab. 45. Screen Enclosures 46. Se • tic Tank or Sewera e 4 47. Shower or Tub Enclosures 48. Steel = Reinforcing & strl, 49. Su.ervision 50. Surveys 51. Tile & Marble "J . Wi " = 52. Water m Public • 53. Water - Well &p _ _ � Y 54. Windows = Glazin_ & Screens _: 55. Window Frames - Concrete - - A kaidaRgii Sholrara Village APPLICATION FOR FINAL INSPECTION Prior to a final inspection this application must be filled out if sub contractors have failed to take out permits the general contractor shall be responsible for the permit and fee. A final i :.3pection must be made prior to the release to Florida Power and Light Co. and the issueance of a certificate of occupancy. OWNER LOT / d '// ' / BUILDER BLOCK 2 DAY LABOR JOB ADDRESS / 2 p SUB. 0j 1 / 11 6 3 61.. t9G> 4 CONTRACT DATE 19 TOTAL A Personal Services B Contractual Services C Material & Supplies D Fixed Charges E Land F Buildings G Equipment H Debt Retirement TOTALS TAX WORK PROGRAMS AND DETAILS A Deputy Assessor at $60,00 wk. B Title Information Billing Machine Service Contract CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION N° 149 Miami Shores Village, Florida, 12 °243 Mr Owner, Agent or Tenant of Building ° 8` Mrs. Jack Moore Lot 10 =11 °12 Block 22 Subdivision Miami Shores Sect„ # 1 Street Address 128 N. E. 94th St. Approved use by occupancy bedroom and bath addition Remarks 4535 This Certificate of Occupancy is issued to the above named owner for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. Plan Cube 10-434 Tax Value 5 W•� BUILDING DIVISION INSPECTIONS DATE BY INSPECTIONS DATE BY FOUNDATION I H. W. HEATER CONN. ROOF SEPTIC TANK M, DA SP ;;,�Nk- 790 -4'`7 BEAMS & LINTELS I e?5�.<< , -- POOL SEWER I $ FRAMING AIR COND. SOLAR HEATER SEWER FINAL CLEAN UP GAS SLAB SEPTIC TANK $ SLAB a SOLAR HEATER SPECIALS PERMITS PERMIT NO. I DATE FEE TEMPORARY SERVICE BY I H. W. HEATER CONN. $ SEPTIC TANK M, DA SP ;;,�Nk- 790 -4'`7 ../$4., e?5�.<< , -- L/ $' "'X as SEWER I $ 1 $ SOLAR HEATER SEWER 1 $ GAS 1 SEPTIC TANK $ a INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING H. W. HEATER CONN. I $ RANGE CONN. $ TUB & TOP OUT H. W. HEATER CONN I $ FIXTURES I $ SEWER 1 SEPTIC TANK FIXTURES & FINAL SOLAR HEATER FIXTURES GAS ELECTRICAL PERMITS & INSPECTIONS CONTRACTOR ( !L, % ..t - 4.- 1 R.)C._, PHONE PERMIT NO. `tCv S 1 DATE /C 2- .-- 4P7 FEE $ 2.QZ SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE TEMP. SERVICE $ H. W. HEATER CONN. I $ RANGE CONN. $ MOTORS H. W. HEATER CONN I $ FIXTURES I $ RANGE CONN. 1 INSPECTIONS DATE BY RE- INSPECT' BY RE- INSPECT' BY TEMP. SERVICE I ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL CONTRACTOR en ec. PERMIT NO. NEW BLDG. NEW BLDG. BUILDING INSPECTIONS "I go" ' 7 ce6a° PLUMBING & INSPECTIONS / c � .,., A , z , DATE 9-4 7 - X018 ALTERATION ADDITION ALTFRATION )- 1 ADDITION APPROVAL TO POWER CO. FOR SERVICE DATE PHONE FEES Q - REPAIRS REPAIRS BY OWN R'S NAME y Mr 0...1 Rs' s. � a►.c..� Ihoore PRESENT ADDRESS 1 �l • t• q4 C 4 . LICENSE NO. PHONE NO. JOB 4 LOCATION (ST. OR AVE.) ` 1 `%. %Z.8 N•`• ` r LOT Io - t%_ 17— BLOCK zz SUBDIVISION � 1 " I F'� S. % w..;.. d�S ra.s cc GENER4 L CONTRACTOR Yr•e• 1 CD L! r% 1 O ■ b ADDRESS 3 ( c 14 . E. . I S`` Cif' es PHONE NO. LICENSE NO. 6.4r BUILDING PERMIT NO. 44 DATE I- �'-eo 3 PERMIT FEE $ -� • BUILDER'S BOND NO. 2 94- DATE 7 C ','t C3 Add / 4Y6ir ZONE REQUIREMENTS CU. FT. 7v. = Sz(7 PLAN CUBE / 43 CU. FT. a EST. COST $ /, 400 DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: a• 0 G - DATE• / - i ; �� NEW CONSTRUCTION TYPE e_ a 5 STORIES On e ROOF CONSTRUCTION -- 7; 4- INTERIOR CONSSTRUCTION G.JQ dm a..., es 3.. 4 ,9. l L t - i-r o 1� DESCRIPTION REPAIRS kh. Sc/I i4 ri., - 4. coo % 41. yea' Qtad fr • h Ave 1 ALTERATION DESCRIPTION /" `` e.).4. as S 4 ... ,( CE //;., ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECT-ED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SURMITTFr) TO VILLAGE COUNCIL REMARKS " CERTIFICATE OF OCCUPANCY NO. /-/`%. / ISSUED /R-,2 �j-IJ. J n Q BY /utR /3- TO 4 -M / 94)1/6.. ,k�i: Z 1 L -2w -(o BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE vP7 APPLICATION FOR BUILDING PERM OT 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 ified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address._ Reg1 tered Architect and /or Engineer... 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)__ New Building Remodeling To be constructed of Kind of foundation Roof Covering_ Estimated Total cost of improvements $____ . _ Q1 o 0 Zone cubage required Distance to next nearest building._ -.___ Maximum live load to be borne by each floor I hereby submit all the plans and specifications fot said building. All notices with reference to be sent to___._ The undersigned applicant for this building permit dot , 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 Law :.f Florida, Pennanent ipplement, yed by him public notice ed under this and has complied with the provisions thereof, and will require similar compliance from all contracto in the work to be performed under this permit; and will post or cause to be posted for • sp c ion o or notices as are required by the Act. The undersigned agrees to employ only such su f . - 7ctors permit, as are licensed by Miami Shores Village. Remarks STATE OF FLORIDA, p COUNTY OF DADE. ss Chatnnan Member Member Council Approved Permit No Disapproved Date (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT /-2 22 - 90 Addition Amount of Permit $ 17- plan Cubage Size of Building Lot (Signed) Date______ No My Commission Expires l Street Date__ �___ __ Read, Sworn to and Subscribed before me. ��. Notary Public, State of Florida PLANNING BOARD.. __ . DATE Member Member Member _Date Disapproved _ .._ _.._ ,19 and for no other purpose. Repairs. No. of Stories sub- contractors emp ite of the work sue ork to be perfo the building and its construction may 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. 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. 4 39' 0 6 -17/9' 1 e_s 1061. • MIAMI 244- 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 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 specid or not. A copy of approved plans and specifications must be kept at building during progress of the work. � T ..'“ Date Owner's Name and Address_aJ _ ? -- 0 P No Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision__ _ q Street and Number where work is to be done /21? 31-ab_ _ 4.4 1 // ( )C- , s �_ _ _ State work to be done and purpose of building (by floors). : - ' . ," `. y� ` Street Notary Public, State of Florida 19 q and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering ez 0 Estimated Total cost of improvements p $ Amount of Permit $ 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 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 insjction e site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub ct on work to be performed under this permit, as are licensed by Miami Shores Village. 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 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 carefull ead the foregoing application, and that he did sign the same, and that all facts therein by hi state e. Permit No ! _ Date Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector 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. 1p., 17 ., l /, " j .n •I C4- �.�. . � - SHtRESV L BUILDING INSPECTION DEPART AP L0CAT9UU G° l '72? Name and address of licensed contractor _ tV Registered Architect and /or Engineer Location and legal description of lot to be built on: Lot-lj - -.1/ ' / Z Block Street and Number where work is to be done State work to be done and purpose of building (by floors) Date Estimated Total cost of improvements $ Zone cubage required 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. be sent to U0= IN Application is hereby made for the approval of the detailed statement of the plans a ing or other structure herein described. This application is made in compliance and co Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordi regulations of the Building Division of Miami Shores Village shall be complied with, plans and specifications must be kept at building during progress of the work. 7 % CO Owner's Name and Address Date_. feb NT All notices with reference GE PEPMOT specifications herewith submitted for the build - rmity with the Building Ordinance of Miami es of Miami Shores Village and all rules and ier herein specified or not. A copy of approved Subdivision,9 t..-. Street 3 o'yl /sy and for no other purpose. New Building , Remodeling -__X Addition 1 pairs No. of Stories To be constructed of Kind of foundation 1 Roof Coring $ 434 T. ✓• 2.17 Amount of Pe Plan Cubage Size of Buildin ot to the ><() 1 19 building and its construction may 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 Sup clement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such s tractors, on wo k to be performed under this permit, as are licensed by Miami Shores Village. 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 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 Disapproved D (Signed) Read, Sworn to and Subscribed before me. Notary Public, State of Florida B ilding nspector 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. - a 2--• fr3 to, d 217 Application is hereby grade for the approyal of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. OwnIr's Name and Address___ / 4� KS - - -- - -l__�. V._t . - _ -- _____ No / 2.-e- -_- Street_---_ _._ 4 ___ • Sic(-e..-^e-l Regiiered Architect and /or Engineer... . iV0/ Ave Name and address of licensed contractor_ C. dr F1 D Q$._ .. -1J5/ �.h'1 _lf %® j_q - 13 Location and legal description of lot to be built on: Lot__ I_o4. I______ — Block Z._ ___ _ Subdivision..._ -1L�_c _ 0 i lls r/ C,S-Q Street and Number where work is to be done / a tr Al E V -¢': - ,4,-X--'� State work M, be do nd p.. ose bui ing (b floors) _ hiz' c [.�� -or;: , / / and for no other purpose. New Building Jf Remodeling__ ____. _.. Addition (l.-_.. __ Repairs__ Nn. of Atone / To be constructed of____e_13s_.. IC4d of foundation ___ ( u i•-) tfi...c.te le Q Roof Covering._ i.A44.. (1" p Estimated Total cost of improvement._b_, ,g..00 - e-c- Amount of Permit $ / 2 ' — Zone cubage required _Plan Cubage 41-5.5 • I...i' Distance to next nearest building Size of Building Lot io A ia ( 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 doc hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen s Compensation Act. being Sec :ion 5966, Compiled General Laws of Florida, Pennanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work yiy be perfor under . is permit, as are licensed by Miami Shores Village. Remarks STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, 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 tted are true. Permit No 0 3 _ Date -- -- J I �- G - -- Read, Sworn to and Subscribed before me. Disapprove _ / ______ _____ _ Date ( Signed) ` ' ` 1 Building Inspector Chairman _ Member Member _ Council Approved WHAM S H J E V LLA .7 E BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT undersigned authority, a notary public, duly authorized to administer oaths and take ack.iowledgments, personally ap- (Signed ) Date_________ Notary Public, State of Florida My Commission Expires to me well known, PLAN j* G 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. Ti 14- (21'71. - ,0 °4? r.. L �,, �& 6 A ce le m ma , J /1-Ltl c c z �,�� s7 _3.e/.37 -3 -I- z7' Disapproved ___ _ Date (Signed) 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. Date Dec_ember 21 , 19..67_ Owrizz's Name and Address... .. Jack _Moore No 28 st N, E, 94 Street RegEtered Architect and/or Engineer . 1, Name and address of licensed contractor. .. . Truly _No len _Inc ., 60.0 Avenue Fla.. Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 1_28„E..___9.4 _Street_ State work to be done and purpose of building (by floors). Fumigation and for no other purpose. New Building Remodeling Addition Repairs.. No. of Stories To be constructed of Kind of foundation_ Roof Covering Estimated Total cost of improvements $ 304.00 Amount of Permit $ 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 foi said building. All notices with reference to the building and its construction may be sent to_ The undersigned applicant for this building permit dot 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 (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, al: 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., Cf Date. %-d T 1. Read, Sworn to and Subscribed before me. Permit No Building Inspect P NNING BOARD Chairman Member ___ Member . Council Approved Date NOTE: A charge of $1.00 will be made for the Planning Board. A re-inspection fee of $1.00 will be charged materials and/or workmanship. I SHORES VILLAGE tLO Notary Public, State of Florida My Commission Expires.. DATE Member Member Member - - ------ ----- Disapproved Date making corrections or changes to this application after approval has been obtained from when such re-inspection is made necessary by improper notice for inspection or faulty APP FOR PERMIT TO FUMIGATE WITH CYANIDE APPLICATION NO. 1. Location of building to be fumigated 2. Name and address of owner of premises IICW Oki 1 ?sin, 3r I-Zes lre 3. Type, size and construction of building ®1 ?"fi f 4an & fbcd 4. Is entire building to be fumigui u : �r 5. If not, state what portion 6. Approximate number of cubic feet of space in building or in portion to be fumigated. 7. Kind and quantity of fumigant to be used and manner of application and length of fumigation period Inkarn Apb ro,A haulm 8. Distance of nearest building and direction from building to be fumigated 9. In what manner will vents to exterior of building be sealed? 'gEl'lal`J!S METHYL BROMIDE ACRITET DATE 19 10. Date whem fumigation will be begun Dec 24 1967 Time U.D(W A t1, 11. It is hereby agreed to station a guard on the premises to be fumigated during the fumigation period and to post suitable placards at each entrance into the building bearing the following words in letters at least two inches by one inch in size: "DANGER" — THIS BUILDING UNDER FUMIGATION WITH A DEADLY GAS." 12. It is hereby agreed to make such provisions that all openings into the building may be opened from the outside after the period of fumigation is over and to take such other precautions as may be necessary to insure that all of the fumigant is removed from the building before anyone is permitted to enter. 13. It is hereby agreed to notify the County Health Department when the building has been prepared for fumigation. FIRM NAME: TRULY NOLEN, INC. 600 N. W. 7th Avenue Miami 36, Florida =4 i / I (Sign re of certif -d pest c rol opera • • in charge of t s fumigation job.) BUILDING MIAMI SHORES VILLAGE FLORIDA . Ei 6 ELECTRICAL ❑ Date 19 PLUMBING ❑ PERMIT N9 9683 Contractor's., ROOFING ❑ License No.' ❑ Work to be performed under this Permit Owner of Building • °i Architect Contractor or Builder Legal Lat 1 ' Description 11 Bl . 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 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 of drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed • , ? ( INSPECTOR) BY 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 nut I assume responsibility for all work done by either, myself, my agent, servant or employee. Subdi- ' vision , 7 Sq. Ft. c_. , c c Value of ,- ) 11 Amount of /r Project $ r ' - 11 Permit $ CONTRACTOR or BUILDER-. BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ 2 Date— 19_5.x, ELECTRICAL ❑ PLUMBING ❑ PERMIT N9 9524 Contractor's License No. ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot 11 Description 11 BI Address of Building CONTRACTOR or BUILDER Subdi- vision Sq. Ft. Value of Project $ 11 Amount of 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 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 • (INSPECTOR) BY 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. BY AUTHORITY t 1 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: 128 NE 94 St., iiiami Shores, F1 33138 905= = Instruction for locating on 5 side of J _94 St. between NIT; 1 *. ve iv NE 2 Ave. 813= = Location: t41 ami ShnrPS SPr_ 1 ..rnri _ 22 1 0, 1 1 1 7 868= = subdivision name block no. lot'no. County: Dade 808 = = Owner of Site: Name: rlakovi, Is Lyon Address: 128 NE 94 St. , NN]i -tmi Shores, F1 33138 Type of Ownership private . 848 = = Recording Date 832 = = Recorder: Name & Title: Newton, Marto, Chairman , & Stof_i k, Marty Address: • MSHPB 818 = = Condition of Site: Integrity of Site: Original Use private resid.838= = • Check One Check One or More Present Use private res id .850 = = ❑� v Excellent 863 Altered 858= = Dates: Beginning 1925 844 = = I - `t9ood 863 == }}�� 858 Culture /Phase American 840 == ❑ Fair 1 863= = - LJ Original Site 858= = Period 20th Century 845 = = ❑ Deteriorated 863 = = ❑ Restored ( ) (Date: )( )858= = ❑ Moved( ) (Date: )( )858= = NR Classification Category: nisi 1 cii rirr 916= = Threats to Site: none Check One or More ❑ Zoning ( )( )( )878= = ❑ Transportation( )( X )878= _ ❑ Development ( )( )( )878= = ❑ Fill( )( )( ) 878 = = ❑ Deterioration( )( )( )878= = ❑ Dredge( )( )( ) 878 = = ❑ Borrowing( )( )( )878= = ❑ Other (See Remarks Below): 878 = = Significance: The E two -story massing of the structure was designed by Robert Law Weed and constructed in 1925 as part of the original Miami Shores development. Weed was one of the architects who helped shape the Mediterranean Revival theme for Miami Shores. The new one -story W massing is in harmony with the original structure. The residence is in scale and character with the surrounding neighborhood. 911 = = 902 = = Areas of Significance: Architecture 910= = ARCHITECT ___ Weed ,__Robert_ Law (Miami, Fl) 872 - - BUILDER - - -- - - -- - - -- - 874= _ STYLE AND /OR PERIOD Mediterranean Revival _ 964 = _ PLAN TYPE irregular; irregular 966= = EXTERIOR FABRIC(S) rough textured stucco 854 = _ STRUCTURAL SYSTEM(S) concrete block 856 = _ PORCHES N, entry courtyard,brick wall connecting front wings, access N ' FOUNDATION: concrete block 942 ROOF TYPE: gable — 942 = = SECONDARY ROOF STRUCTURE(S4 gable, new addition barrel tile 942 942= = CHIMNEY LOCATION: W, exterior, end WINDOW TYPE: wood casement, alum awning 942 CHIMNEY: CBS 942= = ROOF SURFACING: barrel tile = = ORNAMENT EXTERIOR: none 882 NO. OF CHIMNEYS 1 952 882 = = _ = = NO. OF STORIES 2 950 = = NO. OF DORMERS none — -- -- - -- _ Map Reference (incl. scale & date) . Miami Shores Village_Plat 19$0 954 = _ 809 = = Latitude and Longitude: 0 Ir Site Size (Approx. Acreage of Property): i .T1 LOCATION SKETCH OR MAP N Contact Print qi-s-r: tunp no: r .E Cr. Sr.': 7 /0 z 7. l ®_. O. Z 8 N E• fi4 sr. 0 Photographic Records Numbers _ Township Range 53S 41E UTM Coordinates: Zone Fad ng 11 ng Section 1 800 = = 833 812= = 890 = = 860 = = STATE OF FLORIDA DEPARTMENT OF STATE Division of Archives, History and Records Management DS•HSP -3E 9.74 Physical Description CONTINUATION SHEET Site Ncr. Site Name 12S NE 94 St. Miami Shores, FL Structure is a one- and two -story Mediterranean Revival residence. The original two -story structure on E has traditional Mediterranean Revival detailing. The addition on the W is in scale and harmony with the original wing but does not attempt to replicate the original design. A brick wall connecting the two sections created an entry courtyard on the N. MSHPB USE ONLY Replace windows 1951 (not in front of old section) Addition 1968 V) /6 . /5 70 ,9 9 2 a 75' 11111 1111 E /r M E © ono 7 , •f N.W. 5 • '5 u N nue pin On auctioni �mmoo�, ma mm 111111m111P deirpoi meo Ammon •v -YJ• - FO 3 a T ourilludra wittrulaitt N w 1 O G t1g-111x arNadm g g s,. tho impt ma* gem�mia P 411114 ItaggIladt • N W • 1R41601 9 TM N. w• rd ego 0 Ls nate NJ 9.8 , K MEM Nougutim / ®'e MEN N.W. 96T EV1 �mmm 3 2 U 1c /J 5 T: ; 104 5, e : _ 95--• 11111/ mm .. rz s 4 Nw 93 ,, 5 e/ 1. 7. 5 1 1e 6 f , }5 ro o00Pq�� l' � 11111 Meld a unslion mmmmmcvmm 11m11ddm1 arm REMO mlmmmo /1111 m1sleimmdm 1 111 1 w 60. I 0 6 107 lmmm' eaom 111ads� lama INM 5 T. & r• X11 "m 411 5 5 9T. 9r z2 �.T• r a 1•r 5 T. mmmmm�vom elmm O 111�110411 maim LI 7 ST• 9 ,o ma fv .r. W 111 T. K. N. le S ,/.:fl 10 9 ° 107'". 7. 1 ". 4 4 /! 1.1 ; -= 1_ pip -: kd wpm oi 19 19 / .s d 1 °d 1'5911i r ran ID Ira LJ rad 10td1111P l'"llhI 1111111 ;i 7, 111111 Im�almlm Ilev511� 1:. I O ®®OP ®®11 d® m- •memo ® a =� g.: 1°d'11 111111m1 11/1 ammodlo dill MN emc� m� 7, N• N /e Al -�- E ST mm. 1.'19amemmom ;NJ E smog outi 5 i 43 fV.E N E 1(.E dill 11 VIEW to NJ . E :1mcm�mmm E. �mmmmv �, /• 1011 2'•r 10 4 N b, Iwo Pal to s .� . q 1Sr. K. • E 0111 comma •.�� p v RIP f1,.p1 ridge . 1 O d•vmo�oe- 1 O I 10 0 9 9 O 5 MEP aoe =Midi 11 open aae9ooaam mum MIEN 31 5 5 x 2 , 9 8 ' 9 6 '" RION 9 5 9 4 3 2 II . I _ 11 Iii• 11 91 r • 5 T P iu:1115 5- T. 5 T. m 111 m me � oaV � op uit 5 40 uruhis I i s, 0$ ° • �tt HUM ml mm "mee�oamem IITOP isto b 6 5T.a .5 T. 5 T. TRACT q CD •f•ne J7 RO2f Of 1/347 271(00( % CHURCH e mm' ag avid 5 T. :'1 °1 I 1 Ip °1(06 S T 11111111111 mom 11111P5 1111 1 LAKE NE • II I 111110 11 / 11 kg Ili el 1 yeel SHORE .5 CHOOL r. 0 101 • 1111110 111 • Ltiltgatil 110 alninngn 2 4 54 sT BUILDING ELECTRICAL PLUMBING Owner of j Building i Architect ' „ ontractor or Builder Legal Lot Bl. Description Address of Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 10679 Work to be performed under this Permit Subdi- vision CONTRACTOR OR BUILDER BY Value of Project $ DATE 195 Contractor's License No. Amt. 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 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 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 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, assume resionsibility for all work don, by either, myself, my agent, servant or employfe. /f �/e � J.r < s �. j. 1 , AUTHORITY ( l � MIAMI SHORES VILLAGE STATE OF FLORIDA, COUNTY OF DADE. ss. 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. Date / ' / ti , 19.41 Owner's Name and Address / _ 2 -Z-(&- , ' No._2 _. __C Street ���� Registered Architect and /or Engin 7-41S- r, T 7 Name and address of licensed contractor___ �_t Location and al description of lot to be built on: Block Subdivision Street and Number where work is to be done w State ork to be done and purpose of building (by floors) New Building___ Remodeling Addition Repairs ` No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ �� Amount of Permit $ Zone cubage required Flan 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 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 (Signed) 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 Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) Building Inspector 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. and for no other purpose. PAID BY s i YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER l�� I// II i ��i �` • t_ _ ' 4 '' ( _ i �/ 1 /T /. A" - 1 e !' 1940 �® j 1941 1942 6'-O - ' / ■C / /0 0 0 04 7 -44 -3 ®c2/ 120 A _ / -. 7 =-.s- s vi .a�-�d�." 4 = � l 1 / 1 943 (4 9 rJ- /!I • 00 1 - (29 0 J 47fI U 5c 1944 //elk 6 � �n �) / ® �� 1945 I 44—® 7 '161 7 ham. 1946 / ()' 8'• 02-2--/‘ '3o �J fi _ % r w •� 1 C.- / ► (o) 1947 4`D-7,-e_ /!. ) i 194 c� 12 �- YO Q o / Jyf Sj lfl y o() J.2 V F pp a / �n 6p 9 l� 1949 /I /624/' If /.2 - 6 -3 ' „ 0 e/' 9 .3 - i /- 5 //9S> /5 ,9 ,, '' 1950 II LOCATION 128 N. E. 94th Street f, ARBAGE TAX RECORD 12$ N. E. 94th St. by year annual tax Jack Moore /95/ et. period used 3/ 5/ amount paid date paid receipt # BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building ' D D Architect Contractor or Builder Description Lot Bi Address of Building f CONTRACTOR or BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT Np 9603 Work to be performed under this Permit Subdi- vision Sg Ft - Value of Project $ •`' Date — 19— Contractor's License No I Amount of 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 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 ' (INSPECTOR) BY In consideration of the issuance to me of this permit I agret 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. BY AUTHORITY 0 OWNER'S NAME µe, . 4 ArI. . M to t.a. Ay PRESENT ADDRESS 1'3.8 M • F. - 94`. 47fe.ee-t_ LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) 12 N. 0 - 1 el— ` Oree. { LOT lo - II - I�. BLOCK '1;2.. SUBDIVISION IA .o. ' L. See.. I GENERAL CONTRACTOR CNAQi~ES G. WR.1C.1+1 . ADDRESS 410 M -� . I14 STre.e' PHONE NO. LICENSE NO. n o 4. r BUILDING PERMIT NO. q� 0 pp DATE (� « ` p PERMIT FEE $ 1 cp. ,. b BUILDER'S BOND NO. DATE ZONE REQUIREMENTS CU. FT. PLAN CUBE Al Z rr- L CU. FT. ow EST. COST S 4z 041 DRAW NGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: Cam• a- IZea. 14Orm9 a ` p DATE 1- i fe-v$ NEW CONSTRUCTION TYPE e vs g STORIES on e ROOF CONSTRUCTION INTERIOR CONSTRUCTION -r; ie. 1 8a.1 roo..% 414.4 Samoa. Ali ii%;_ REPAIRS 1(n� -10...- I DESCRIPTIO / 1Ir �. ®� t /0 °r 5 CdrefeTtnT pi.•4e - e 1. dJv.1i1 &.J. �@I JI'4 ALTERATION L l DESCRIPTION �®mi 6 &5t 62. 4.r\.... 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. ISSUED BY TO BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE INSPECTIONS DATE BY INSPECTIONS DATE BY FOUNDATION $ SEPTIC TANK ROOF TEMPORARY SERVICE S BEAMS & LINTELS $ TUB & TOP OUT POOL SOLAR HEATER $ FRAMING $ GAS AIR COND. MOTORS S FINAL S FIXTURES CLEAN UP SEPTIC TANK $ SLAB S SOLAR HEATER SLAB SPECIALS PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE RE- INSPECT BY $ SEPTIC TANK FEE TEMPORARY SERVICE S SEWER $ TUB & TOP OUT $ SOLAR HEATER $ RANGE CONN. $ GAS SEWER MOTORS S RANGE CONN. S FIXTURES e INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING DATE FEE TEMPORARY SERVICE ROUGHING $ TUB & TOP OUT $ RANGE CONN. SEWER MOTORS RANGE CONN. S FIXTURES SEPTIC TANK $ S SOLAR HEATER FIXTURES & FINAL FIXTURES GAS CONTRACTOR PHONE PERMIT NO. I DATE FEE S NEW BLDG. I ALTERATION 1 ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE ROUGHING $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS RANGE CONN. S FIXTURES $ S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL BUILDING INSPECTIONS CONTRACTOR PERMIT NO. NEW BLDG. PLUMBING APPROVAL TO POWER CO. FOR SERVICE DATE PERMITS & INSPECTIONS DATE I ALTERATION 1 ADDITION ELECTRICAL PERMITS & INSPECTIONS PHONE FEE S REPAIRS BY MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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 Jack Moore •128 N.E. 94 St. No Street II. Sh ores Registered Architect and /or Engineer Name and address of licensed contractor. The..CQn el1.--C 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) Tear -..off and for no other purpose. New Building Remodeling Addition Repairs. .Tear .off No. of Stories To he constructed of Kind of foundation Roof Covering.. -Red..$ , �t - -- Barrel Tile Estimated Total cost of improvements $ 640-..00 Amount of Permit $ $5.00 /1 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 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 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 fro 11 contractors or sub- contractors employed by, him in the work to be performed under this permit; and will post or cause to be posted nspection on the sJ of the such public notice or notices as are required by the Act. The undersigned agrees to employ only sue subcontractors, on Ql k to . rformed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) Permit No Disapproved (Signed) Date 3 Date BUILDING INSPECTION DEPARTMENT Date 128- .N..E.--- 94- --5t-. -E. - -- She -re& June 14, 1960 ,19 STATE OF FLORIDA, COUNTY OF DADE. J ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated true. -60 Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector 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. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date q- q g7Job Address / ,oil q Tax Folio Legal Description S — p F Historically Designated: Yes No Owner/Lessee / Tenant (( /" I A 14O V l Master Permit # Owner's Address / a � 8 NE g et,5 / Phone Contracting Co. \et ( C R. Address ifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): 6 1T.DIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION G OA( C E re 5 -g8 /2 if pp rf Square Ft. 902 t WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and/or Condo President Date APPROVED: Zoning Building Mechanical Estimated Cost (value) 4o 0 ' Signature of Contractor or Owner- Builder Date 0 Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date My Commission Expires: My Commission Expires: FEES: PERMIT 'Yo. RADON C.C.F. -6° NOTARY BOND TOTAL DUE 9'S - ` moo 1 Electrical Plumbing Engineering t f q rI O f Ov,' I74 7 62,Y _�''J! t%/6" w10 / 1 - - LINO �i f� 1� � got? Tar is iN 5 *`6 egoreW E $L 4 1/ t cvo Rocks Fo1i' FR 4:4 4h' Ytei C- y 7 CONCi ri S Li6E - 4 5"6: IT' 5,7,5 rag ( &oSqi ✓ Pri 33' Date Type Insp'n Permit No. Name Address Compan Phone # Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buildin: Inspection Request \o L / '- CS- Date Type Insp'n Permit No. Name Address Compan Phone # Inspection Date Approved Correction Re-Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 ���,, Building Inspection Request \� CLEA o`2005 /c9 1U E;t.6 ( Co q -- 535 (Rev. 04/24/03) Address Building Officials Approval: Miami Shores Village Building Department Certificate of Re- Occupancy The following residence is issued a Certificate of Re- Occupancy /(0 iU6 City Miami Shores State Florida Zip 33/3 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No. "Pn goo Date This certificate 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 solely to the requirement that each one - family dwelling is used and intended to used for a one - family dwelling purpose only; however, this certificate does not constitute any representation or warranty as to the condition of the 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 the premises in order to determine the condition thereof. Rev. 10/02/03) RE- OCCUPANCY APPLICATION Property Address cal \k „ Sign: L-LA ➢ Y A Ci Q Print: 6...0 i.S DL F My Commission Expires: Miami Shores Village Building Department Date y^ U k^aco5 Contact Name ' J e_ LOWLY Buyer Seller Realtor City Miami Shores State Fl Zip 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 the property. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate. Applicant Name 1 `.0. j Signature The foregoing instrument was acknowledged before me this if day of , 20 0 S� by S who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NDLEY tL My COMMISSION # OD 381851 R f AN i Na 1 tA de ity here Building Officials Approval: 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756-8972 Permit No. KI- Loc ID (0 U II 535 Phone # 305—0094 (e Company Name \\e.i W,`l t�, a(L1 Re -Occ. $60.00 Notary $5.00 CCF Total Zb 92 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building inspection Request Date /Z9 /0 Type Insp'n Pe- cCC. y Permit No. VOZG3- 1 5 Name S La(jjorm Address Company Phone # /ZS q4 5�- I lcr wi /1 i c --ms 30 -6Q4 -536 Inspection Date /- Approved Correction Re- Insp'n Fee Rev. 10/02/03) RE- OCCUPANCY APPLICATION Date p ' - 0S°® City Miami Shores Sign: Print: 0 My Commission Expires: Building Officials Approval: Miami Shores Village Building Department ,d. L 7,1 17 Skwe. Lcu State F1 2K5 Contact Name Buyer Seller Realtor '- Property Address E c t4 OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate. Applicant Name Signature A i e VjV LOIS E UNDLEY MY COMMISSION # DD 361851 EXPES: er Bonded i Notary Public U ndeiwii 15, 2006 e�y 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No.EDZCC5 _ /5 l Loc ID Phone # BbS - (o -5350 Company Name 6614 1.1lii1 ctl Zip 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 the property. , 20 a S� The foregoing instrument was acknowledged before me this , c day of by 5k Lcuose-IA, who is personally known to me or who has produced p as identification and who did take an oath. NOTARY PUBLIC: Re -Occ. $60.00 Notary $5.00 CCF $0.60 Total 60.60 e73