CO 1966OWNER•S NAME
Le CLAussE
PRESENT ADDRESS
s40 GQA+JD CONC.
LICENSE NO.
82 d9
PHONE NO.
JOB LOCATION (ST. OR VE.)
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LOT
A
BLOCK
1 1 11
SUBDIVISION
I ic ; .1 PI elY a. r"
GENERAL CONTRACTOR
DEa.-4 2. CLAussc14
ADDRESS
SAb G QANI - Co NC-.
F'1-IONE
LICENSE NO.
k z 47
BUILDING PERMIT NO. 1 ^/ ry L 5 1 G
DATE Z - z £ ( 0 6
/ J
PERMIT FEE $ (.o T oo
BUILDER'S BOND
NO. 2 Co 44+ DATE 2- 2 10 1
ZONE Z ZC REQUIREMENTS 2 0041 CU. FT.
PLAN CUBE 2S c i r4 CU. FT.
EST. COST $ /U o 0 d
,
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY:LA 2 1� • vseAD�^ e I:,
DATE
2- 2S: L L
NEW CONSTRUCTION TYPE
Ce3s
STORIES
o ric
ROOF CONSTRUCTION INTERIOR CONSTRUCTION
- f,le. I30¢- 4 coca4 - Z 3..4 -4. Zcs, 4c.,c
REPAIRS
DESCRIPTION
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ALTERATION
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DESCRIPTION d
LL. S,t(& -
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
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CERTIFICATE OF OCCUPANCY NO. Jp/
S / U D TO •'� Co. Co.
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BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE
INSPECTIONS
DATE BY
INSPECTIONS c D
BY
FOUNDATION
FEE
ROOF
ROUGH ING
I
BEAMS & LINTELS
$
POOL
SEPTIC TAN K m
/Q4`
FRAMING
r� -r-qj
eL $
AIR COND.
SEWER
2.ro
FINAL
1
CLEANUP
SOLAR HEATER
SLAB
SEPTIC TANK
$
SLAB
$
SOLAR HEATER
S
SPECIALS PERMITS
DATE
PERMIT NO. I
DATE
FEE
TEMPORARY SERVICE
ROUGH ING
I
$
SEPTIC TAN K m
/Q4`
-. To. � vP}ry
r� -r-qj
eL $
c731(
SEWER
2.ro
H. W. HEATER CONN.
1
$
SOLAR HEATER
SEPTIC TANK
$
GAS
$
SOLAR HEATER
S
$
FIXTURES
16
INSPECTIONS
DATE
BY
RE - INSPECT
BY
RE- INSPECT
BY
ROUGH ING
NEW BLDG. I.-- 1 ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS PERMIT
TUB & TOP OUT
FEE
// NO.
TEMPORARY SERVICE 17379_ ML-Ci.#
'c
u��
LAC, 3-Ilt(
2.ro
H. W. HEATER CONN.
SEWER
$
RANGE CONN.
SEPTIC TANK
MOTORS
$
SOLAR HEATER
$
FIXTURES
It
GAS
CONTRACTOR Mri,.,e_id el. ec._ _
DATE
PHONE
RE- INSPECT BY
PERMIT NO. 7s' 13 I DATE d - 4 ?- o ( 2
TEMP. SERVICE
FEE $ 3 7
7 .-'
NEW BLDG. I.-- 1 ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS PERMIT
DATE
FEE
// NO.
TEMPORARY SERVICE 17379_ ML-Ci.#
'c
u��
LAC, 3-Ilt(
2.ro
H. W. HEATER CONN.
RANGE CONN.
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
It
INSPECTIONS
DATE
BY
RE- INSPECT BY
RE - INSPECT BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
•0
V
BUILDING INSPECTION � �e.s � � "
CONTRACTOR Jo at F S
PERMIT NO. - 1 . 11
NEW BLDG. Y 1 ALTERATION
PLUMBING PERMITS & INSPECTIONS
p (_. J m i Iti( r.,
1 DATE 3 - 3 -
I ADDITION
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE
BY
PHONE
FEE $ 30
REPAIRS
,l
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
N° 1692
Owner, Agent or Tenant of Building Dean R. Clausen
Lot A Bl ock 1 � 9 Subdivision Kinne
Street Address
Cube - 28, 954
1030 N. E. 99 St.
Miami Shores Village, Florida, 12 -2 7 -66
Park
Approved use by occupancy 3 bedroom - 2 bath residence
Remarks- 7 2 5 9
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.
LDING DIVISION
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of '
Building
Al
Architect
Contractor
or Builder t,
Legal Lot A II B1 i ` Subdi- Description vision 1<' ^f t I C `1 _
171- a
Address of "` a ''
it r Value of r -' " 1 Amount of , J
Building 1 i' 3 1 f— t F f +. '' rat
Project $ 1 Permit $ f
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 applica-
tion 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. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. 7 ` if
Signed. e. INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance wit* all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorties of Miami Shores Village. In as
cepting this permit I assume responsibility for ell done by either, myself, my agent, servant or employee. f
MIAMI SHORES VILLAGE, FLORIDA
141. r DAT 191
❑
PERMIT r , `
�� 9 � Contractor's . ,
'License No.
CONTRACTOR OR BUILDER
Work to be performed under this Permit
C..
1 t) C.
BY AUTHORITY .eor
G '
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 proress of the work. .64t
Date !T , 19
No Street
Owner's Name and Address__
Registered Architect and /or Engineer
Name and address of licensed contractor_______
Location and le at description of lot to be }I yn•
Lot_,___ —__ — _ Block 1 l / Subdivision 1-
Street and Number where work is to be done_
State work to be done and purpose of building (by floors) — - --
New Building Remodeling ,_.__ Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
__ p
Estimated Total cost of improvements $ /e6.3.61.- Amount of Permit $ �v Li " a
___Plan Cubage o f 4- t i • Zs
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, 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 in .ection on the site of the/ ork such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su tractors, on wo to ]fegp formed under this
permit, as are licensed by Miami Shores Village.
Remarks_______- (Signed)
Zone cubage required_
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 7 Z' �7 ___ Date 2 - Z 3 ' tAc, Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
APPLICATION FOR BUILDING PERMIT
D
Building Ins r ector
e - 1'7'41
MIAMI SHORES VILLAGE 7 i
BUILDING INSPECTION DEPARTMENT
and for no other purpose.
Notary Public, State of Florida
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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