665 NE 97 St (11)f
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.
,19 9 6?,0
Owner's Name and Address..... 271,7 O3 s38 e �� . No (lv 46 street ___ /- ....�� G
Registered Architect and /or Engineer
.r oe
Name and address of licensed contractor a`l/L U : ■c^ ' e
Location and legal description of lot to be built on:
ry �d
Lot._ r:;S6�lS__.J9 Block O ®Q Subdivision 4�
Street and Number where work is to be done 6 Al
State work to be done and purpose of building (by floors)
STATE OF FLORIDA, +
COUNTY OF DADE. j ss
Disapproved 3 1� Dafe
(Signed) -
rt.
Date__.
Remarks (Signed)
SAo c G�
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind f foundation Roof Covering
Estimated Total cost of improvements 3 -2 __. ® (5 ' 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, 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 public notice
or notices as are required by the Act. The undersigned agrees to employ only such su contractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
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.
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.
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 C $1 #9 Block /) 1 -
Street and Number where work is to be done
State work to be done and purpose of building (by
STATE OF FLORIDA,
COUNTY OF DADE. ss.
f abate
1i a� �
1AI�II S H O RES_. VI LLAG - E
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.
and for no other purpose.
New Building Remodeling Additi Repairs 1__ No. of Stor'
To be constructed of Kind of foundation _ Roof Cavering
Estimated Total cost of improvements $ 0'0® Amount of Permit $ � G �
it
Zone cubage required � ' . �1 O __' _________________ _Plan Cubage 1_R T '
T i. .
Distance to next nearest building
Maximum live load to be borne by each floor U
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 . .10 • Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from ,all contractors :'sub ontractors employed by him
in the work to be performed under this permit; and will post or cause to be poste o inspection o e it: of e work such public notice
or notices as are required by the Act. The undersigned agrees to employ only ch`ubcontracto - . to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks
Notary Public, State of Florida
Before me, the undersigned authority, a notary public, duly authori ':'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. f
Permit No !!__f!- ___S@ Date ��2yy Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Building Inspectorf ° 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.
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Permit No l
building during progress of work/
Owner's Name and Address
^ O Service Underground Site Feeders.. <<
Overhead
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
/
Date...,,(
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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
Registered Architect and /or Engineer
Employing Electrician's Name ..0 e No. ... �� d/ Street 1 " ..
Location and Legal Description Lot / � ' ! ' ,j - Block Subdivision.._.
v
No.il ...;
Street and Number where work is to be performed —No (� Street o f 2
State work to be performed and purpose of building (By Floors)
New Building... Remodeling Addition Repairs No. of Stories ✓
f �
Conduit ! Main Sw.
Type of Installation— Conduit Tubing.... ' B.X.L Metal Moulding
(Signed)
/
Street
a
Amps Main Fuses..... Amps
r
Electrical Inspector.
The undersigned applic for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida rkmen'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 subcontractors 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 sub-contractors, on,work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) ...
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NTE: A re•inspection fee of $1.00 will be made when such re• inspection is made necessary by improper notice for inspection, or faulty
mater' is and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
N O. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
H EATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
n
Li 14
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/.00
;T
/
3
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
/..p.
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
/ 0 6 0
Permit No l
building during progress of work/
Owner's Name and Address
^ O Service Underground Site Feeders.. <<
Overhead
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
/
Date...,,(
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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
Registered Architect and /or Engineer
Employing Electrician's Name ..0 e No. ... �� d/ Street 1 " ..
Location and Legal Description Lot / � ' ! ' ,j - Block Subdivision.._.
v
No.il ...;
Street and Number where work is to be performed —No (� Street o f 2
State work to be performed and purpose of building (By Floors)
New Building... Remodeling Addition Repairs No. of Stories ✓
f �
Conduit ! Main Sw.
Type of Installation— Conduit Tubing.... ' B.X.L Metal Moulding
(Signed)
/
Street
a
Amps Main Fuses..... Amps
r
Electrical Inspector.
The undersigned applic for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida rkmen'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 subcontractors 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 sub-contractors, on,work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) ...
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NTE: A re•inspection fee of $1.00 will be made when such re• inspection is made necessary by improper notice for inspection, or faulty
mater' is and /or workmanship.