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1020 NE 99 St�� OWNER'S NAME 7 5 'z A.,3 Z. CL.A. b S e•N PRESENT ADDRESS t I o® t4..l..- / e � ,4 LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) lin I O 4, ® ti.. E... i �fr2n LOT BLOCK SUBDIVISION I� W NI AZE. `l - ?..q. re... v.._. GENERAL CONTRACTOR �a� ‘2. a-L.AsS ADDRESS Im ®� I�I.E ` )T PHONE NO. LICENSE NO. 4- S" G` � BUILDING PERMIT NO. 1 8 / DATE 11- 1 `®� low PERMIT FEE $ S-� BUILDER•S BOND NO. .2' 9 4 � ` DATE II - ' Tv . II, FL 4 ZONE `G `Ea REQUIREMENTS 1 .0. ®o6 CU. FT. PLAN CUBE `�3, 1 7- A CU. FT. EST. COST $ Ir® ® DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: 0... I�•1 . M, Ac�.�, (*,�._ DATE. I I— 1 4.- L® NEW CONSTRUCTION( TYPE �i . � STORIES aea Q. ROOF CONSTRUCTION " ° = INTERIOR CONSTRUCTION I 3 % e • 2. 'B*. 04- 'R. s REPAIRS DESCRIPTION 1 n {' Tee. rs C1. 2.•.e. oe .. b p k. // Qi. f+• / tea. /lj ,7.... d e., 4.. - APO/ " ALTERATION / DESCRIPTION & .d 1(tt os.a - " ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTFn TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. I Y.( ISSUED 12-1-34.( (�J BY ' • `(�J { (/ TO Dr-At 1 / /1 /� ` S S C� I Z— r —c. BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE INSPECTIONS DATE BY INSPECTIONS DATE BY FOUNDATION I ROOF DATE FEE -.'.EAMS & LINTELS '4 y - C.A.4- , Iter- - POOL do • . . ' FRAMING 126.' • > 2 4 (C AIR COND. $ I FINAL CLEAN UP FIXTURES SLAB I SEPTIC TANK S GAS SLAB S SPECIALS PERMITS PERMIT NO. DATE FEE TEMPORARY SE BY ROUGHING DATE FEE S SEPTIC TANK ' SEWER 46 do • . . ' %r.. (C Q,,. $ I S SOLAR HEATER FIXTURES I SEPTIC TANK S GAS S FIXTURES a INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING DATE FEE TEMPORARY SERVICE Soo s 5414 Ed Q -4otc.. /mZ;Jr _ N. TUB & TOP OUT I-''.-CJ c-4.4 $ MOTORS SEWER $ FIXTURES S SEPTIC TANK 5 SOLAR HEATER FIXTURES GAS 1 CONTRACTOR S03 S -7E - 7/L/0._ Co . PHONE PERMIT NO. Hal I DATE I = co FEE $ 3-a 9e. NEW BLDG. 1t I ALTERATION 1 ADDITION REPAIRS . SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE Soo s 5414 Ed Q -4otc.. /mZ;Jr $ '2 �� $ H. W. HEATER CONN. RANGE CONN. $ MOTORS $ FIXTURES S 5 INSPECTIONS DATE BY W RE- INSPECT BY RE- INSPECT' BY / filO- c� TEMP. SERVICE / ' ROUGHING A'dL H. W. HEATER CONN RANGE CONN. FIXTI IRFS !t FINAL ; - PERMIT NO. ;I NEW BLDG. J C)p J p'I PLUMBING PERMITS CONTRACTOR 1'•-. k 4 /©p I BATE c I ALTERATION ELECTRICAL PERMITS Be INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE BUILDING INSPECTIONS IL • )9765 . & INSPECTIONS /1— as _ ADDITION PHONE FEE $ A 00 — REPAIRS BY M V QI CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION N° 1285 Owner, Agent or Tenant of Building Lot B Street Address Miami Shores Village, Florida 12 -5-61 DEAN R. CLAUSSEN Block Subdivision KENNY PARK c N.E . 9$t St. Approved use by occupancy 3 Bedroom, 2 Bath Res. Remarks. 978 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 23,892 TAX VALUE 11,964 BUILDING DIVISION 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-4 - : A No Street 4 Registered Architect and /or Engineer ............. Name and address of licensed contractor Location a legal description of lot to be built on: Lot Block Subdivision.. Street and Number where work is to be done .r ate . _ __�J• State work to be done and purpose of building (by floors)._ New Building modeling - Addition_ . j To be constructed of _ . Kind of foundatiQ Estimated Total cost of improvements $ /?f. Zone cubage required e_0 9 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. 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 -con ctors 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 - •k such public notice or notices as are required by the Act. The undersigned agrees to employ only such s ontractors, on w t . rformed under this permit, as are licensed by Miami Shores Village. Remar k s (Signed) f ft 7 ned / C` / / g ) - Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT ate Chairman Member Member and for no other Repairs No. of Storief Roof Covering Amount of Permit $_.)L plan Cubage `>1. 0 is� C5 Size of Building Lot AO u ' ,'e 3 r ift -tea, 4 1,111' g , ih � �r7 e r rr urpose. STATE OF FLORIDA, COUNTY OF DADE. as • 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._ c) Date ( l °tom b Read, Sworn to and Subscribed before me. Notary Public, State of Florida ng Inspector My Commission Expires PLANNING BOARD DATE 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 /, X ,yd7Q,) q,�- i i 1 6o100 / ) OD 0 3, r, A' A/ Pg ere a s ■ 9 07 r;.-•.. t d