1200 NE 96 St (12)BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building J 2.y
Architect
Contractor
or Builder
Legal Lot Subdi-
Description Bl. vision
Address of r: G .
Building /V
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. -r condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsi ility for a thoroug knowle• •e of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings r in the st ments or specIC• and at he assumes responsibility for work
done by his agents, servants or employees.
In consideration of the issuance to me
pertaining thereto and in strict conformity with
cepting this permit I assume responsibility for
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N° 4899
Signed.
r
CONTRACTOR OR BUILDER BY
Work to be performed under this Permit
Value of
Project $ 4 '• !? Ka
INSPECTOR
of this permit I agree to perform the work covere• ` ereunder in compliance with all ordinances and regulations
the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
all work done by either, myself, my agent, servant or employee.
DATE-4 —W 195
Contractor's
License No.
Amount of
Permit $
/S
AUTHORITY
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 January 15 19 77
"r 1 T rir (9 l `I r r ra, ?
Owner's Name and Address. -...J .s_. a.._. -. --? .... ti - c . . ,, ---- _ - - - -- Nd.2Q�... T'�._1,.. Street 9 �1 w,C .- __ �. -r
Registered Architect and /or Engineer
Name and address of licensed contractor T' 11.G T L.,T•._ 37.th
Location and legal description of lot to be built on:
Lot Block �� Subdivision
Street and Number where work is to be done ' 00 1�T.: 96th. .�,ree "f; l�'j_3I71j_ J)10J�o
�'-.
State work to be done and purpose of buil -(hy floors)
New Building Remodeling
To be constructed of Kind of foundation
Estimated Total cost of improvements $ 146 s 00
Zone cubage required
Distance to next nearest building
Disapproved Date
(Signed)
Building Inspector
PLANNING
Amount of Permit $
-Plan Cubage
Size of Building Lot
OARD DATE
and for no other purpose.
Addition Repairs No. of Stories
Roof Covering
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 - E_(?f4e 1 'aetta s— 1-- -e. 50 - - -- z.�a. � 37th ..I v Ei`i?�:E3 ....__ i;7 a2 -3 - 5 A 1-o- 1 -:; :..
The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
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 staled arp,trub,,
Permit No 4 _. __.4 Date Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
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.
NO,R
WEST
EAST
120
PIzQPzttry L�y6
LaTa R9 ¢ 2 ol B"cl 04,Miiu&i Sit 0RI.S
i kz a
N. L. 96T' 5
99 PLPT PL AIN '