990 NE 94 St (8)1
•
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Addressl /-
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
� 1
Lot 1
Bock Subdivsio __ _ d"
Street and Number where work is to be done - .)J f ,
State work to be done and purpose of building (by floors) �_____�
STATE OF FLORIDA, 1
COUNTY OF DADE. j ss.
Chairman
Member
Member
MIAMI SHORES VILLAGE
Remarks
New Building Remodeling Addition
To be constructed of / 1 ! Kind of foundation_ 14___
Estimated Total cost of improvements $__
Zone cubage required
Distance to next nearest building
Date
s
No Streetri '
, 18__
and for no other purpose.
Repairs No. of
— — = — — _ Roof Coyering- —> L — - - - - - - --
— Amount of Permit $
d
2-f _ Size of Building Lot__
_Plan Cubage
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 Corhpensation 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.
Before me, the undersigned authority, a notary public, duly ..uthorized 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 arefully read the foregoing application, and that he did sign the same, and that all facts
therein by him sta;ed ar true. ',
Permit No — Date A 4) _I__,( j Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Notary Public, State of Florida
Building Inspector J (Oiy Commission Expires
PLANNING BOARD DATE
( Signed) —
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.
4 2 a
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the 'Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date..._...
Owner's Name and Address ....... l- U._1.11. r ._ No...7
Registered Architect and /or Engineer ,5C- . ..c.i'c G.. /. c 6-1't ••• ..,...
Name and address of licensed contr4etor $ r 'e r / & V .5 :0 1.\1 - W 2 -'7 •..G' t `, c/'��°i
Location and legal description of lot to be built on: 3 3 3
Lot Block Subdivision
Street and Number where work is to be done 4,....d5
.. .d z" ' '
State work to be done and purpose of building (by floors) -lb.0 r -e t e ,5 / �.,() 9 ..a O 1 J./1/1A.._...._..c..4 C/N
g . 00 . . . . C.. A.E,..cttni.1.,.r.c4.m....4.Q.U! ..._ Wi.r..t±... .... Zi I /e 00E-
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of ?n Roof Covering X
Estimated Total cost of improvements $ c7 q ! 66 Amount of Permit $,. I - -C2.0
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
Remarks... (Signed)
_ .__...___..... ,19..75
Street_Ju._.......9 `i' 2/
be sent to...
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor 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 . performed under this
pennit, as are licensed by Miami Shores Village.
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, raid that all facts
therein by him stated are true. 9 r �� ��
Permit No.._ 1 � _ 0 / 0 Date . R ad, Sworn to and Subscribed before me.
s Notary Public, State of Florida
Disapproved ate
(Signed) r✓-
Building�nspector My Commission Expires
PLAN) C BOARD DATE
Chairman Member
Nfcrnber 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 Ice of $1.00 will be charged when such re- inspection is made ne:a=rsary by improper notice for inspection or faulty
materials and /or workmanship.
0
pole
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vrezi
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0
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0
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1 STY. C:. B. S . M
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sc.� t._.>✓ 1' _ moo"
Oi
M AGEE & HAWKINS SUBDIVISION,
Lot 4,
4 ( according to the Plat thereof,
recorded in Plat Book 51, at page 5,
of the Public Records of Dade
County, Florida.
Order #3909 December 27,195
ri F.B. #53 -7 Scales shown
a
SKETCH OF SURVEY
For
Dean R. Clauesen
I HEREBY CERTIFY: That the attached
"SKETCH OF SURVEY" of the above
described property is true and
correct to the beat of my knowledge
and belief, as recently surveyed and
platted under my direction.
rry C. Schwebke
Registered Land Surveyor # 6
. State of Florida ,
00
•
V
-O
4
' i ORDER" :NO; 125088: I HERE-
.. , 1 BY CERTIFY: That the
attached SKETCH OF
52 SURVEY is revised this
15th day of September,
1975.
I SCHWEBKE - SHISKIN &
ASSOCIATES, INC.
By :i ../ ' �ud�e
Richard P. Shiskin
P.L.S. #975
State of Florida
e 1
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MARK TYPE
4.2 E 510 400
0.2 ■ L67 500
COLUMN AND BEAM SCHEDULE
SIZE
b 4 b' IN, 544; t, t
THICKNESS MAX. BEAM SPAN SPACED C -C
is E4/t. 4 0 0 7'-O' 9' -O
.100 .004
.007 11'- 0' 191.5' 10 • 11 ' 14 0
241.0' 14' -0
7.1
702 1
903
100
775
07,
1010
009
700
004
1004
990
004
574
551
920
302
402
401
752
1.2
240
320
$40
444
431'
4155A
4104
455VA
•0
6106
1415'
649V
0504'
704
75610
1354'
7552'
7010'
%0201
MARK
4.2
402
902
•
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A
A
A
a
A
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5
0
0
0
0
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6
6
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TYPE
0
L
96C.
465'.
MEMBER
202
202
201
1.2
1.2
1.2
142
1.
2.00
1.012
5.00
9.20
150
9.04
435
R00
ROO
5.00
4.00
400
1.0
5.00
100
525
572
1.00
240
2.00
1.X
207
1.07
100
2-00
1.00
100
21.0
100
1.00
2.00
Loo
1.00
240
2.00
2.00
2.00
2.0
b
207
240
200
200
2.00
740
1.341
500
9.50
7.70
070
1110
900
000
7.00
500
1200
500
'40
744
515
290
2.00
4.00
6.00
7.00
3.00
100
0.00
S00
5.00
4.00
4.00
6.00
4:60
400
200
6.00
0.07
100
6.00
7.00
700
7.00
7.00
Roo
7.61
4.00
447
4.00
402
5.00
5.00
.3.20
14'1
170
9.00
207
000
400
400
100
1.20
5.30
104
4.10
200
4-00
512 1`
b'
244
2.00
I.20
I.25
470
170 425
1.25
129
5.04
0.44 1.25
1.25
1.44
1.20
6.44. 425
545 1.00
.100
.125
.100
.110
420
.159
.000
.004
.125
.125
.140
0.24
.100
.110
.112
.135
9.00
5.00
.000
.000
.150
.100
.150
160
.150
DISCRIPTION
*TIM T0102 o, 2.014 0EA50
47207. TO RAVE 4ELTION
01'11 RAIL TO 401.01001
04416E155 9211.002 J01450
05151700116002 TO COLUA
0ERI64105 0EA0•0 10 CONCRETE
P4R1017E2./4A0C4 TO A4 2Y
0121007101. A2/6054 TO 9000
.070 .017
.070 .125
090-.024
.050
.coo
.070
480
.00
1.60
.0'6
.070
.024
444
.046
.074
.074
.022
.040
050
.02
.061
.ate
.042
.100
.100
.100
.07
.000
.12
.125
.140
.022
.020
450
.104
.120
.120
.090 ,450 .190
360 460 .200
DESIGN CRITERIA
8461.L11 000145 V11.17 1.010 6 OUT 15 049
i54 1449, 0120 1460 14 4 OUT 10.0 • 4 9
%27F1 000162 LIVE L0117 WAN - -- 7 049
004162 •1140 .069 Ur 7 059
7.051' L069 IS 4 475114 10.0 959
00(050241 AT TOT LAID - 0070 NN.
00RJLTON 11/47 67 90+145 LOAD - L /1•
GFNERAL NOTES
.005
.055
.185
.000 .OS(
.090 .0
.054 .oe5
449 .055
. 118
.025 .055
.140 054
.100
.140 .019
.155
.140 .055
.140 .055
.120 .002
.100
.104
.150
.108
.570
THICKNESS
t1 t2 t5
.060
.050
'10
.044 .264- .007
.055 .055
.055
.140
4 .053
.060 400
.050 .050
10'-11"
15 -4"
11 0'
21
241.0'
14'6"
ZD
20 =II'
51'-6'
We'
94
.1_
35'10'
a
40,0'
5 5. 5 '
MAX.
4/-O'
16' -0'
MISCELLANEOUS FASTENING SCHEDULE
FASTENEk
2-510 • 5 /4' 4. 5..5.
" 05 2. /A. 4.
2- 40.34' 414.
1- 010"3/4.' 4..D. 6.
2 -51033 3 4' 4.0, S.
6 ANLNOI. O 50' 0.1..
• 4144.404 42 0' '.1..
610.1 4.5.6. 5 20'0.e.
SCHEDULE
11' -•
»' - 1
21
27
32'-0'
57
44'-0'
IV - 2'
20 -1'
30' -9'
55' -ll'
45. 5'
21
25
91 1 1' '
54'-4'
0
17
24
52
19 ' -8"
I0' - 1'
13' - 0'
12'-0•
12'0'
51 0'
11' -0'
20
21'
20
50
50'- 2'
51'-2.
34
20 1. 3 '
37
44
.OL. S
51.0'
13 -0
IN -0'
4.1.5'
KEY
17 1_ 1 '
37.0' 2e-4
34 -4'
20' -0' 10' -0'
24' -te 24
50 74
51 59'•9'
41' - 4' 92
15 21/
53 32' - 1'
45.4' 40
20' -4' 10
29 Id 25
301.0' 30'-4'
92 -2' 90' - -11'
40 90
0 -0 8
14 15
24 23
00
29 -10'
115 -11' 111_
" -6'
11' -0'
17' -O•
17 5'
20
5'•2
20'0'
14 , . 2 '
171.4'
20 -5'
22 3'
25
92'-0'
35 - "
34 -11'
42
DAN S
` r -
12 4"
2'- 0•
4 , 5 "
9,.5.
19
0 , -7 '
II' -0'
o'
6= 2'
33 -0
6 , 2'
10
10
19
34' 4'
2
17' -O'
17'- 0'
90 47
31
331.4'
39 - -2'
51 -10'
RACED
1 r -O .
11' -6'
11'•2'
5 , -
••
5 , - 5"
12' - 7'
6049 -7.0, Y6 • 14 061
COLUAN5...
60033-74, 49. 20 441
6444? 354.2
4043 -10. Y6. 252.41
4461.4.4...
4065 -T4. 44. 10 041
CONNECT024...
2024 -14
27
30=4'
25-7'
27
47
57
14.6'
29.10'
30.7'
944.7'
10'- 0'
29
20
7 5_0'
4' -7'
21
10'
0
ALUMINUM ALLOYS
SO- SNAP 054n
NV -*lie MA 5/law auerrf
464A -500 PEAD 5/ IL ALM4405 *TRAPS
412,24.5NAP 122AA 1//14000 1545574 MI. 515M0.
4C -our 401-UAN
462'1+. CARS
2 76164024
/NUT; 41
+44041,0. 51.02Y2
452 44ALS-
55T 4 61D16 0441.1-24 0,4E2E0 514452E51 An.. 501144 4044 05 45EATEa 00E11. THe 2001104 401.19
51201 OR +14/74 AX7E2141.5446L1 1477 02 PRIZAITTEDUNLE+4 C0•4140122 [YY 744E 9421/40-ER.
5.1114 2 4 IA* ARE FDRADETER OR &am RAIL 454E425
4. wet Hu VANE 57.0tEDD1OSE +10441 2001•1226.01.15 4CsECuLE,USE ADDITONAL 4275 OF CAE4.55.
411. COL140414 4.0LU. tf MATEN10 70 5EA05 OR STRITIS MTH FASTENERS 072E2 INAN INTEMIOR 402555,
cwarsce ONWARD. 44. 4580(47
ALIJA, ALLOY 2024-74, 404 FASTENWIDS MY 56 81.1.114E 0500E OR FAANETIC STAINLEDS 411-
1.54474 OF 515605 9 4.156R10 TV Oe POZ or M. SPAN 4 OLACCP 1.1 .0.07G2 Of 4949•
4. MEL ORA? OA* FIDER STRES5 Of 000D Mi. ErT4a +0.102' 9c25544 GA. M44 OF
4fAN.17.80554 ELECTRICAL. TAPE .02 ASP4A1.1"1719 TOPE 1.055.0 ON STL.INSECT5 ILI eiNTACT w/84-UA. CONG.
10. A1.1.66407077 AN664012.146 02414.54 6661.1. 44 NAM /4910,021224150 AETALL1C 4.75147. OR AWE 00
II. L04.5y42T +70.070 PE4IAN ANY BE 04517 IN PLAGE oF 00u40 40ULRE 50.0.15. TliumpERDLLTA, *iv .1.4s 4.A. it.. Jorx41-.1
II WERE fAlLT414514E+5 MEM: COAAERCIALSOLE24141.4. 21•1.000 40..0t1E.D. P701012 1020 02 41 5511.41-.
NUT* 4 l'
4,44. ARCADIA
7.400 AGA15512
5
Die 521-12CD
102 a
6E6 620;PAL NOM 0 b.
TYPF
TyPE '11
(sow)
TYPICAL PLAN
MEM
rzscamem
AIL
44 1Mt
t2
hw
ELEVATION 11070 1 v2,4701410 RAIL
1
COLUAN
I I 1
MEM
DETAIL 9
TYPE 'L
TYPICAL' clAr
SIDE
VIEW
'a TYPE
seW
DE TAIL
DETAIL 4
TYPE 'E'
TP
mb." 7412U 50.T4
202
13401 eflA
DETAIL 2
44 000
RAVE
20
5E :USE
s6/271■21620,T4 TO 02414 4410
2Yee 4.0.4.1D 4114C.14
10 f74
TOF
TYPE 'F'
IMP
2.0'
102 02 701
I 05.4n
DETAIL 5
L 24.50c
umit-
at
2-16' 24.5Ts TO 040.5
DETAIL 6
MINIM
2.0'
Ple 71.420101.14(L6
VEDOLT
' 4725149714 IN4
202
13.5618 02 /
%le 44. CANS
242' 71140-44.60V4
1,20a'ec5401.4 0204478
Wye +4.6410LO
teAA
DEAD
EAVG
COQ. 5E11.
L .0110
TYPICAL
ANGLE
AD 024o
010 4V1' RAJ
ROTE NO CADLE* OR OW*
411781 AYE TULLY
ROOF BRACING SCHEDULE
SCHEMATIC PLAN
15
gnu,. AL. ALLoY
AM- T4
TV 9711.114
STRAP DETAIL
MISCELLANEOUS
541 Mew
DETAIL 3
oueLIN •10 4.A.4
I MAD
111.1111.11 LEM=
t.464 240 5A. T121.+6 OR 260%2
Lco
544 41
441.14 0176
COMPONENTS
ALT. DETAIL 3
21W TO 202
0 51411 4100
665 NOM MOW.
NiTilF
DETAIL 10 EA . EMI"
DETAIL II
.044'
201
ALT. DETAIL 3
ELK ATAIDER
DETAIL 8
STRAP. AI.. ALLOY
eAVe 520000
ClitUAN
GAVE 555oce
CAVAN
fff 00,2 SCREEN ENCLOSURE F OR
CONSULTING ENGINEER
ALLAN A. KOZICH, PE
1220 NE 41I". AVENUE
FORT LAUDERDALE, FLOR IDA
Job Name K. ...k)6hNSed
Job Address q70 / Z 9 ...Sr
Lot '7' Block
Subdivision /(4 6f EE — g.4G) ke -Ai$
❑ Screen ❑ Cei ings ❑ Railings
L.
Mao
Job
No
.SUES
tit
.6141/
cA
solo lees
•
Date Issued
Date Wanted
No. of Panels
No. of Panels
Beams 1X
Color Roof
Sides
Ch. R1.
Uprites
Bm. Ntch.
Cables
Install.
Travel
Complete
Date
,O,O7- / Wa,l
X Customer's Signature
27
R S
R S
.v, 7s
OWNER'S NAME
I___ R. CLAUSSEN
PRESENT ADDRESS
152 N. E. 101 Street
LICENSE NO.
- PHONE NO.
(�
__
•B LOCATION (ST. OR AVE.)
930 N. E. 94th Street
LOT
Pi.
BLOCK
44___
SUBDIVISION
McGee- Hawkena Subdv.
GENERAL CONTRACTOR
DEAN R.. CLAUS$ I
ADDRESS
152 N. E. 101 Street
PHONE NO.
LICENSE NO.
#4065
J�
BUILDING PERMIT NO. #106o6
,1
DATE -3- -51
11
PERMIT FEE 6.00
S L
BUILDER'S BOND
NO. DATE
ZONE PEQUIREMENTS 22,500 CU. FT.
PLAN CUBE 2 CU. FT.
EST. COST S 1$4000.00
Tn
DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: 3DH/
DATE
3...3-51
1
NEW CONSTRUCTION
CBS
CBS
STORIES
1
ROOF CONSTRUCTION
Tile
INTERIOR CONSTRUCTION
o
Terraz Plaa.Walla & Cella
REPAIRS
DESCR IPTION
V —; us— ' -• • - . _ 1 rn • -.
• _ " i -
ALTERATION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
Y/
CERTIFICATE OF OCCUPANCY NO. / /(/ /
{,/ !�7
ISSUELj�/�
n
BY (/ /J /V'-
TO LPL — � i /cede --
AligG:ze___
BUILCSING PERMIT AND IN'SPE.CTION R RD -MIAMI SHORES VILLAGE
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FO LNDATION
J /1-5)
DATE
FEE
TEMPORARY SERVICE
$
SEPTIC TANK
BEAMS & LINTELS
/ /f s/
' M
'
' +
r
SEWER
RANGE CONN.
FRAMING
I /_ /i - Y
SOLAR HEATER
$
$
GAS
$
$
r
$
FINAL
DATE
$
-
DATE
RE- INSPECT
BY
CLEAN -UP
BY
RE- INSPECT
BY
ROUGHING
/� /L' SI
PERMIT NO. Jo 6 4 U 1 DATE j— 9 war s
FEE $ ! 3'.761 ''..
NEW BLDG. I ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
DATE
FEE
TEMPORARY SERVICE
$
SEPTIC TANK
J
$ , O 6
/
H. W. HEATER CONN.
$
SEWER
RANGE CONN.
$
SOLAR HEATER
$
$
GAS
$
$
r
$
INSPECTIONS
DATE
$
INSPECTIONS
DATE
RE- INSPECT
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
/� /L' SI
ROUGHING
l — ./0 -'J l
rat
1 l
GAS
H. W. HEATER CONN
SEWER
RANGE CONN.
SEPTIC TANK
! -4-5"1
/
FIXTURES & FINAL
SOLAR HEATER
/
FIXTURES
/�
L'Z�' 1
f
CONTRACTOR ,i�� �,/ - �
PHONE
4,'
PERMIT NO , a DATE Z. / 6 1
FEE $ /4Z
NEW BLDG. I ALTERATION ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
/ // ., 7
/_ /1
/
J
$ , O 6
/
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
/
ROUGHING
l .2. • i7
rat
1 l
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
r�
` '2.t'p-
BUILDING IN EC O S
P
PLUMBING PLRMITS "& INSPECTIONS
CONTRACTOR
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE
PHONE
Disapproved ........
(Signed)
MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed statement art 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 *II rules and
regulations of the iiuileling 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.
7.4•4 Date....r ..�......_w...._._...... ,1984
Owner's Name and Address .Q. e e RT. L_ . 394) ....... street_Ate. q #..o7ELr r
Registered Architect and /or Engineer .... .i � ..) �• 1 Rio 1EiY04 .Q Q•4 „ &O
Name and address of licensed contractor...... .C. ! R.....i. 7.tM5o
Location and legal description of lot to be built on:
Lot T Block Subdivision. ..4E _.. 14 W-R1lia_
Street and Number where work is to be done Q 14 ' .. -. 5nSF.ir_.. . —
State work to be done and purpose of buildinga(by floors)....,/ p.L.710 'b RESI_O..E bt11C E
DEN Snot p
BUILDING INSPECTION DEPARTMENT
_._ - ..._........and for no other purpose.
Ncw Building Remodeling Addition. Repairs No. of Stories j..._ _
To be constructed of Kind of foundation Roof Covering M
Estimate Total cost of improvements $..7..G.0.a r iffilmilui Amount of Permit $.
Zone cubage required _..- ....Plan Cubage 'ZOic till
Distance .to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
p
be sent to.. RO.Q.ENT L Tpiu.�✓$ a' — 1410 .. 1)'.1�.r_ 1 ... EE.TREEr
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 con ct s or sub- s employe by him
in the work to be performed under this permit; and will post or cause to be posted for insp to rk such public notice
or notices as are required by the Act. The undersigned agrees to employ only such s�� /�ubcoy , , • �perfotTned under this
permit, as are licensed by Miami Shores Village. � 400,, Rem:uks .__.._.__ (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. Di() Date C� i 1 ' )t Read, Sworn to and Subscribed before me.
Ate
Building Inspector My Commission Expires. ........
._._
PLANNING BOARD DATE
Cieairinan Member
Member Membcr
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.
Notary Public, State of Florida
ADDRESS /
• ��
LEGAL
RECORD GARBAGE TAX
PAID BY
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
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ADDRESS /
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LEGAL
RECORD GARBAGE TAX
ADDRESS
RECORD GARBAGE TAX
PAID BY
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE
PAID
RECEIPT
NUMBER
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ADDRESS
RECORD GARBAGE TAX
Owner of
Buildin
Architect
Contractor
or B
SSW
Le Lot
Desoaiption
Address of
Building
This permit is
herefor in strict wan
drawings, statements or
time if the work is not done in ao
granted it the understanding thit
to the work coveted > ',
d agents, servants or emi4oyees.
108i9
Subdi-
vision
Vcifina of
Protect
ACTOR OR
It
vprk eo�*ered der in pi em >> all
M ica to the proper .a titles
my agent, serva rt or employee.
N° 1108
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miami Shores Village, Fla ,
Owner, Agent or Tenant of Building - f
Lot d Block Subdivision +'
Street Address
Approved use by occupancy
Remarks.
f
•
BUILDING DIVISION
This Certificate of Occupancy is issued to the above named
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.