842 NE 99 St (3)Date
Type Ins
Permit No.
Name
For Inspector:
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection R
—'` Address V 'r c 5
Company .6Y
,Phone #
Name & Date
(c)
Miami Sh
10050 NE 2nd A
Phone: 305 -795
Printed: 3/18/2003
Applicant: HE
Owner: DE
JOB ADDRE
Contractor
Local Phone:
Parcel # 1132060340130
Permit Status:
Signed:
X Signed:
Pay
to the order o
Nati o
HERB E. DEUSCHEL
PH. 305- 751 -2142
847 N.E. 99TH ST.
MIAMI SHORES, FL 33138
7J 7 / Si /6,z3—s
d e 07
sBank
NationsBank, N.A.
ACHR/r063 47 J
Memo (J ( ,/ef?? �
1:06 300004 ?I: 00 1 4 6 380 2 38 411
Fees: Description Amount
FEE2003 -1590 Building Permit Application Fee $60.00
FEE2003 -1591 Notary Fee $5.00
FEE2003 -1592 CCF $0.60
Total Fees: $65.60
Total Fees: $65.60
Total Receipts: $0.00
APPROVED Permit Expiration:
Work: INSTALLING GUTTERS
9/14/2003
Date
VV1111 QVIVI .7 r .1I c oo .
Construction Value:
G o
1 $(Q.ss>
$500.00
63 -4/630 FL
1122
InAsOsa
DO. lack.
ige 1 of 1
Legal Description: MIAMI SHORES SEC 8 PB 14 -33 LOT 18 & W1/2 LOT 19 BLK 169 LOT SIZE
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
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. 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 responsibility for work done
by his agents, servants or employees.
(INSPECTOR) BY:
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity
with the plans, drawing - statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either
myself, my agent, se a is or employes.
(Contractor or Builder) BY:
PROPE' OWNER / / ,
Nam • p - ! 41 ,
/ �-anuw / ��
V
Addy::'
Home Telephone 9
_ $ - 3 / C 9 ( u.1044.4. )
Business Telephone5b
-. 5 _ / ,. a (e G(.t)
�
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
Job Address: / A/C 9916 SIy e IMM-(n ( .S f
Address Apt. City /. /
Folio Number " Description of Work Torid/Gfi
Lot Block . 1-40 uS.0 _
Subdivision - PB PG Zoning Linear Feet
Current Use of Property Square Feet n Units Floors
Proposed Use of Property Value of Work r 660 Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
15
Master Permit No. 52
Subsidiary Permit No.
State
0 4 1 5
�3t
Zip
aN
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1° Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choos; +g a Contractor.
ST e FLORIDA, COUNTY OF MIAMI -DADE
Signatur
Print Name
Sworn to and subsc
Signature
SEAL:
before me this
Notary Public - State of Flori
day of
OAP (tY PV t CJh t:Am d ��;
,
" 'Ymml l€NNWMPU
' vu' • a 0001 t :4
o �� MY ®dMMI §§I0?I @? PIn €§
ofF� MAR _101 _ _...
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
PERMIT APPLICATION
Personally known OR, Produced Identification Personally known OR, Produced Identification
Type of Identification Produced: Diz N /O.i 1 Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY
TYPE
Dryer
QTY
TYPE
Outlet, Appliance
Q•rY
'FYPr
Service Repair
Q•rV
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
Signs
-- -
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE QTY.
Minimum Fee
TYPE
Condensate Drain
QTY. TYPE
Generator
Q•rY. TYPF: QTY.
Refrigeration, Tons
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
- Process/Pressure Piping
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
-- -
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPE
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
CHECKLIST
CI OWNER - BUILDER FORM
(Attach)
FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
Di CONCURRENCY
(New Construction)
LI OTHER
(Specify & Attach)
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
Notary
CI PROOF OF OWNERSHIP
(Attach)
HRS / DERM APPROVAL
(Septic / Sewer)
CI IMPACT FEE
(New Construction)
LI OTHER
(Specify & Attach)
PERMIT FEES
$3.00 per page (Scanning Fee) $
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
62-0 ( sq.ft. = x/1000
x ¢.60)
$ (¢.005 /sq.ft.)
$
$ 6.00
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
3800
(¢.01 /sq.ft.)
PERMIT APPLICATION
LI CONDO ASSOCIATION APPROVAL
(Attach)
• BPR APPROVAL (Restaurants)
• CONTRACTOR REGISTRATION
(On File)
TOTAL $ le 5 - W 0
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com
Date Job Address
Legal Description
Lessee / Tenant
Owner's Address 4 '
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
1 // 1 1,57: Tax Folio
Phone 7 Q V
iW 4 ZA ie. / //C Address 4i4 S • /0�(//7' ` l !/°-
��r � SS
109;
��=�- � 4� Phone
State A tp #
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Contracting
Qualifier
F Competency 1 Ins.Co.
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL •OOFING AVING FENCE SIGN
l/ tit
Signature of owner and /or Condo President
D
Notary as=4
My Commissr
oxF
I�n,,
grim won 3
i m
ssIo
�. s res .
AL'
ident
* * *
FEES: PERMIT 30. RADON C.C.F.
Fire
Buildin
Mechanical Plumbin
APPROVED:
Zo
WORK DESCRIPTION
Square Ft. / efIrOes Estimated Cost(value) Cl 90, '
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zonin: Furthermore, I
authorize t e above -named contractor to do the work state
ature of Co
•
Dat
Notary
My Comm
* * *
ARY
Master Permit #
afE
P ;mission #C
or Owner Builder
q ¢ilder
327872
* * * * **
TOTAL DUE 3I,
Other
Electrical
Engineering
System.Number
Deck
Deck description
Insulation
METRO -DADS OFFICE OF CODE COMPLIANCE
PRODUCT APPROVAL SECTION
• y3- 0:i2).,
Approved: DEC 0 6 1993
Expires: , Q 6 1996
1 (Awaplan)
Steel/Wood
18 - 22 ga. steel deck, wood plank or min. 5 /8" plywood.
New construction and reroofing.
For steel decks Iess than 22 ga. but not less than 26 ga. TPR fastener
and Olympic 3" round or SFS type 'S' suess plate may be utilized at a
density of 1:2 ft.'. Field fastener testing is required on all re -roof
projects to confirm a minimum Nvithdrawal resistance of 400 lbs..
Vapor Retarder (Optional) (Optional)
(Steel decks only)
Any Factory Mutual approved vapor retarder with proprietary or
approved adhesive. See Factory Mutual App,ov -I Gt f listings
First ply shall not be bonded to wood de y. rosin i • ;-n _v uc
applied below the base sheet over woc-1 ;,od decks
(Optional for wood decks only)
Wood fiber; fiberglass; perlite; polyisocyan r.,,e p�. »c
composite; basalt rockwool (See Approved Insulations and Fastening
Patterns List.)
(Recover)
Moisture content in an existing built -up roof rnust be in compliance
with Section 3401.9(c) of the South Florida Building Code. Prior to
application, all existing roof surfaces used as a bonding substrate shall
be tested for uplift resistance in compliance with ASTM E- 907 -83 to
the calculated design velocity pressure of the roof deck. Existing roof
surfaces and dissimilar materials must be fully primed with ASTM
D -41 primer and allowed to cure. If insulation board is bonded to the
existing roof or to a base sheet no one dimension should be greater
Gil Diamond, P.
Basesheet
Flysheet
Membrane
Surfacing
FIashings
Fastening
Acceptance Number: 93- 0525.3
Approved: 46 p 6 1993
Expires: k34 U b 1995 ..
than 4 ft, Elmore than one insulation Layer is applied, the top layer
may be mechanically attached or bonded in a full rnopping of ASTM
D -312 type 111 or type 1V asphalt.
Note: No insulation panels shall be bonded to an existing built up roof
with a gravel surface without full removal of the gravel, priming of the
surface, and a flood coat of asphalt, prior to mopping of the insulation
with bonding asphalt.
Option #l: (Wood decks only) Mechanically attach one ply of
Tamko Vapor -Chan or Tam -Cap (granule side down). Mechanically
attach 9" o.c. in the lap and 13" o.c., two rows staggered in the center
of the sheet, in compliance with the pattern detailed in Appendix 'A'.
Option #2: (Over insulated steel deck) Mop in a solid mopping of
type III or type IV asphalt at a rate of not less than 20 -25 lb. /sq. one of
the following asphalt saturated membranes:
ASTM D -2178 type IV felt (Tarn-Ply IV)
ASTM D -2178 type VI felt (Tam -C :.;s Premium)
ASTM D -4601 type 11 bases'ir'et (Glass-Base)
AST;`'f D -2626 Organic basesheet (T ?r' s tvt 3 base
sheet)
U.L. listed, G2 Versa -Base
U.L. Listed, G2 Versa - Base FR
One, two, or three plys of Tam -Ply IV, Tarn-Glass Premium, Versa
Base, Versa Base FR, or a combination of these ply sheets mopped into
20/25 lbs. per square of type III or type IV asphalt.
Awaplan Premium FR, Awaplan Premium, Awaplan Heat Welding
(torch only), Awaplan 170, Awaplan Versa - Smooth, or Versa-Cap FR
applied in 20 -25 lbs. per square of type 1I or type IV asphalt.
Where the modified bitumen top ply is a smooth surface material, the
membrane shall be coated with a minimum 40 lbs. of asphalt and 400
lbs, of gravel per roofing square, with a minimum of 50% adhesion, or
an approved emulsion or aluminuni coatina. Coating shall be applied
at the rate specified for ' rt equi fire classification.
A Tamko polyester reinforced modified bitumen flashing material in
compliance with the appropriate Tamko specification.
See Approved Insulations and Fastening Patterns included with this
. Gil Diamond, P
- 4
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.
Owner's Name and Address / --» fU CST ._ No..? ... Str ee .. Z_.. ....._.
Registered Architect and /or Engineer ... . ..
Name and address of licensed contractor. .. eoVelTt ,l !. ...I..� j 100G _..... .. , i2..77
Location and legal description of lot to be built on:
Lot Block s Subdivision .
Street and Number where work is to be done C
Sta a w.rk to be ay4 purpose of building (by floors)
1
New Buil
MIAMI SHORES VILLAGE
Disapproved .... __.._
(Signed)
Building Inspector
Chairman
Member
Member ......
s to c- _... - f`
and for no other purpose.
Remodeling. Addition Repaira.�.- t A�Aio. of Stories /
To be constructed of Kin of foundation
Estimated Total cost of improvements $ " 4550. ob 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 sa buildjng. 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 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 tractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)` -� -40- —
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 _..
Roof Covering
12 - S -0
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 tru
Permit No.. ___.. Date a Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLA s1T NG 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.
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.
Owner's Name and Address
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date._..._ . ..._--Pt. , I _
/e./9 RJ K.........f''" t/ .... No. P.50' Scree % 1
Registered Architect and /or Engineer
Name and address of licensed contractor... ti, br_ lei7e1!.�✓ .._eI / � �o� 0
Location and legal description of lot to be built on:
Lot Block
Street and Number where. work is to be done
Stale work to be done and purpose of building (by floors)
1..t/!? � .r-- .3. and for no other purpose.
New Build
To be constructed of Kin of foundation Roof Covering
Estimated Total cost of improvements $ 5 .5O.0 Amount of Permit S.
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 G`-� i t� / /
•
v S 4 1 : bclivis; fr ,1 .2 4 ,,
s �
• __
Remodeling _ Addition Repairslit
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 public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcgiltractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
ta*+fo. of Stories
l
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.._..___ Date Read, Sworn to and Subscribed before me.
►
Disapproved Date
Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairn,nan Member
\lcrnbcr 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 heen 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.
BUILDING El
ELECTRICAL ❑
PLUMBING
ROOFING
Architect
MIAMI SHORES VILLAGE, FLORIDA
Date
❑ PERMIT N? 9357
9
Owner of a `'
Building r` =,
Contractor
or Builder p• ' } ` 'r* f p, ? xie
Legal Lat 11 s�
Description 11 B1
Address Building of
/1
CONTRACTOR or BUILDER
Signed• {
Work to be performed under this Permit
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.
Contractor's
License No.
7
2
BY AUTHORITY
Subdi-
vision
Sq Ft
Value of 11 Amount of
Project $ / 11 Permit $
(INSPECTOR) BY
In consideration of the issuance to me of this permity to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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 . /Jg ✓r b Qq . ,1917
No. __ -DOL Street__ NE•
Owner's Name and Address 23 U5/I I
Regfsiered Architect and /or Engineer._.
Name and address of licensed contractor C Aim, Tf+ gooFl Co � A/(
Location and legal description of lot to be built on:
Lot Block Subdivision
&Ya_ fvE
AiEw /goof Oil/ i1?iiV TI o//
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
N W
1 Sr
and for no other purpose.
New Building Remodeling Addition ✓ Repairs No. of Stories !
To be constructed of Kind of foundation Roof Covering ag4 v4 L
Estimated Total cost of improvements $ �,�2_r_,. __ _. Amount of Permit $ g• 00
Zone cubage required _Plan Cubage__ _.
Size of Building Lot
Distance to next nearest building
Maximum live load to be borne by each floor___
I hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may
be sent to__
The undersigned applicant for this building permit doe, hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5968, 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 such subcontractors,) work t. perfo • .
permit, as are licensed by Miami Shores Village. -
Remarks _. ( Signed )
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. te
Permit No ! 3 S 7 Date__._ Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Buildiq$nspector My Commission Expires
Chairman
Member
Member
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.
Council Approved Date Disapproved
Notary Public, State of Florida
PLANNING BOARD __ . DATE
Member
Member
Member
Date