1200 NE 97 St (9)MIAMI SHORES VILLAGE
UILDING IiNSPECTION DEPARTMENT.
APPLIC TIDN F R ;WILDING PE MIT
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 riot. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date... . e u3: , a92
Owners Name and Address . C
Registered Architect and /or Engineer
Name and address of licensed contractors rV\r\
Location and legal description of lot to be built on:
Lot Block t)
Street and Number where work is to be done ..._..
State work to be done and purpose of building (by floors) ) .hl. s\f, Pxl� 1LY0iL ._ 1 =
New Building Remodeling Addition
J,t -k.°� .......... ..
t v ' I a U tit -t_.
Subdivision..
*sod for no other purpose.
Repairs No. c? Stories
To be constructed of ..1„4..'.. .t Kind of foundation._ Roos, Covering
Estimated Total cost of improvements $ 1( Amount of Permit A. /-` `
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 ss j / mit all the plans and specifications for said building. All notices wit h reference to the building and its construction may
.`
be sent to._. —S _ t --S 1,' ?:ERI/ICE .111; :y 5 5 Pb —; '74 .Sr -..
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 ublic notice
or notices as are required by the Act. The undersigned agrees to employ only arch subcontrn as, on work to dormer under this
permit, as are licensed by Miami Shores Village.
Remarks._._ —.___ . —_ (Signed).. 7 /.. ,.
STATE OF FLORIDA, 4
COUNTY OF DADE. ss.
Before me, the undersigned authority, a pray publi , duly authorized to administer oaths and take acknowledgments, personally ap-
peared / !
and who, being by me first duly sworn, upon oath deposes and says that he is the. tf ��jJ
of the above described construction, that he has carefully read the foregoing application, and that he did sign the mane, and that all facts
therein by him stated are true.
Permit No.._ -_._ Date Rea , worn to and Subs before •anc .
Disapproved Date L z:e,.
( Notary Public, State , i� Q - a .
Signed) J eG., . • • _ o
-0tfhi'!l�Si� ±y t':S{tierr -s °.. Wiz 6 -
Chairman
Member
Member ......
Council Approved
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.
Building Inspector
My Commission Expires
PLANNING BOARD DATE
to me well known,
Member
Member
Member ...._
Date Disapproved Date
making corrections or changes to this application after approval has horn obtained from
when Such re- inspection is made necessary by improper Retie Cos usav 5irrra es faulty
t
\C\C:'
ITEMS
NAME CONTRACTORS & SUPPLIERS
NAME & ADDRESS
1. Arhitectural Fee •laps
• a• LT
2. Asphalt T'raiks. drives, etc.
m
3. Cabinets o Bath Vanit
0 cc - C e�� .
I, Cabinets - ICi'%ohen
-
5. Cabinets Medicine
6 L., r.c
6. Cabinets = Unit Closet
---
7. Cleaning
C ac ,
8. Clearin: Site
9. Concrete o Foundation,Slabs,Beams
10. Concrete o ti Jalks, drives , etc._.��
11. Contractors Fee
Ce,r -c
-,
12. Electric Fixtures
0' - t,u c , ce„42--
13. Electric Wiring
v 2A a ; C-r ci r2
14. Equippent Rental
C2-0 c.c. _
15. Excavation
,%
16. F?'.ii for S1 b
17. Floors - Finish wood & kitchen
`-
18. Floors - Terrazzo
19., Garage Doors
-'"'
.
20. Glass Slidin: Doors
c.-cl --- .
21. Hardware o Finish
• i.
22. Hardware Rough
6
23. Heatin:
24. Insurance o Liabilit .com..-bond
- c s 1� -
25. Labor - Pa ol.1
��c F �-,
26. Labor - Contract
-a-
27. Labor = Contract
---, -
28. Landsca ing, Fill, Gradin: 0
4---
29. Lath Plaster. Stucco
--
30. Lurber A11
�'- c6 - >eC.,
31. Nasonry Labor
__ .- 6 -c i ,
32. Nasonr Materials Block
it
33. Millwork
-
34. Miscellaneous
---
35. Ornamental Iron ?•Jork
•-
36. Oven & Plate - Built in
,-
37. Overhead
38. Paintin:
. , - ;+ - , 6 w - r'-
39., Permits Tem.orar Power
,-
_
40. Piling Foundation
-
41. Plumbing Complete
AR t4 --, c •_ .
_•
_
42., Pool = Swimming
P--
_ _
_
,
43. Roofing & Sheet Metal liork
-
44 o'oof Trusses - Pre =fab.
'--
45. Screen Enclosures
""
46, Septic 'Tank or Sewera:e
47. Shower or Tub Enclosures
48. Steel - Reeinforcing strl.A
---
'; ' - q t r . r
49. Supervision
50. Surveys �
_
51., Tile & Marble
52. Water - Public
53. dater = Well & Pum•
54. Windows - Glazing _& Screens
Go Fc` ,�
55. Window Frames m Concrete
-
Prior to a final inspect n 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 inspection must be made prior to the release to Florida Power and Light Co.
and the issueance of a certificate of occupancy.
OWNER
LOT tU
SIGNED
MIAMI SHOLIS VILLAGE
APPLICATION FOR FINAL INSPECTION
JOB ADDRESS 12 t'C e 9--
c
2Z BLOCK SUB. 62§/ -��y
DAY LABOR
CONTRACT
DAA
U6-. �� 19
56.. Builders Bond Must Accompany This Application for Final Inspection
• TOTAL