1130 NE 100 St (14)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 7 ee,. 1 S• oD ' Job Address /I 30 N 6 1 o C' s i .. Tax Folio
Legal Description Historically Designated: Yes No I/
05Tra S •
Qwner's Address // 30 "...if 112 0 S 4 --
Contracting Co. yc >*l �. C o" S' i Co - Address
Owner/Lessee / Tenant
Qualifier 1 EL
SS# & ' Phone 9 6 ' 3 ` , o 2 //
4 )5 .76cs .107
State# C'G :J r7)/ t e, Municipal # Competency # Ins. Co.
Architect/Engineer 6 C 2 e k T 1> ,v Address 1/6o/ u �C .4 `l ti L U
Bonding Company 14 r4 Address
Mortgagor /1* Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION I S c
Square Ft. Estimated Cost (value) d00. 00
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 c pJnce with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stat
FEES: PERMIT
APPROVED:
Zoning
Mechanical
IYI c c th A-A/*
Cxi S i idrl4 Loa>k
c2/1V
e of owner and/or Condo President Date
36, • o- Lid; s- a
tary as t. • er
My Commission Expires
A esi. LA M BEC
: ` � 0 COMMISSION NUMBER
(!.'4
' CC786697
j, �� MY COMMSSION EXPIRES
` f‘O NOV. 15,2002
RADON
Building
C.C.F.
No
My
Plumbing Structural Engineer:
Master Permit # z/906 3
Phone 7g7 /77/
Electrical
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cifillikili3FATE OF FLORIDA
COMMISSION NO. CC714103
,,My COMMISSION EXP. MAR. I
NOTARY 5 s 0 0 BOND
TOTAL DUE 7/
/ -DO
er- guilder, Date
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SW 3Z a '' a Ye a 1
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Date
12�21
CERTIFICATION OF BUILDING PERMIT
REQUIREMENT
This form MUST be completed by an authorized
person on behalf of the city /county building authority
where the repairs to the damaged property are to be
made.
If a Building Permit is required, a copy of the permit
must be attached to this form.
Seismic Study
Return To:
For construction of a new building, or an
addition to an existing building, the building
authority must indicate whether Seismic Safety
Requirements are in place.
Small Business Administration
Disaster Assistance - Area 2
One Baltimore Place, Suite 300
Atlanta, Georgia 30308
OSTROWSKI, Dale C. and John J.
.3302 -01432 /DLH 40453840 -06
TO: Local Issuing Authority
of Building Permits
RE: Building Permit Requirements
Seismic Study
✓DATE: �� R D
CERTIFICATION OF BUILDING PERMIT REQUIREMENT
For property of: Dale C. Ostrowski and John J. Ostrowski
Located at: 1130 Northeast 100th Street, Miami Shores, Florida 33138
Please certify below the appropriate status regarding the Building Permit requirements for the above referenced
property.
A Building Permit is NOT REQUIRED for the repair /replacement construction on the above
mentioned residence.
A Building Permit is REQUIRED and a copy of said permit is attached hereto.
Pursuant to Executive Order 12699 on Seismic Safety of Federal and Federally Assisted or Regulated New Business
Construction, all new building construction that is assisted by the Federal Government must meet Seismic Safety
Requirements specified in the National Earthquake Hazards Reduction Act of 1977.
Please certify below regarding compliance with said requirements when loan funds are to be used for the
construction of a completely new building or an addition to an existing building.
�}- All new building construction on the above mentioned property meets the "1988 National
Earthquake Hazards Reduction Program Recommended Provisions for the Development of
Seismic Regulations for New Construction."
/y16 Local building code does not include Seismic Safety Requirements.
After completion please return to:
vSIGNED: r
TITLE: ?IA tch rj OT{ 1 C -�i q l
U.S. SMALL BUSINESS ADMINISTRATION
One Baltimore Place, Suite 300
Atlanta, Georgia 30308
• R. 77v Le=3/L)
•
APPLICATION FOR CERTIFICATE OF RE-OCCUPANCY
hereby apply for a certificate to re- occupy the single family residence known as: (add)
// 30 /t 7
Contact Name: Telephone:
Buyer: Seller Realtor Company Name:
Inspection: By
Comments:
•
moved: Denied: Date: G°
7 5 7 Yr
, Mani Shores, Florida.
Legal description
Lot: , Block ,PB&PG:
I hereby certify that I understand that the zoning of the property is for single- family residential use
and that it is unlawful for more than one family 'to reside therein. I also understand that any
Certificate of Re- Occupancy that,may be issued by Mani Shores Village, Florida, certifies only
that the referenced property is being used for single - family purposes and that such Cernficate does
not constitute any representation, warranty or certification as to the condirion of the dwelling or
other structures on such property. %
Print Name: /UGC /4• to
******„****************** * * * * * * * * * * * * ***sas * *** * * * * * * * **
For the purposes of conducing the inspection required by Section 902 of the Miami Shores
Development and Zoning Code, contact
Application Fee (S50) Paid: Cash: Checdc(Number: K- 7
ff
CERTIFICATE OF RE- OCCUPANCY
On behalf of Miami Shores village, Florida, the undersigned certifies that the property described
in the application has been inspected for the purposes of re- occupancy pursuant to Sections 901
and 902 of the Miami Shores Land Development and Zoning Code and that such property may be
re- occupied by the applicant for single - family residential purposes.
THIS CER 11r"ICATE VERIFIES THAT THE REFERENCED PROPERTY
HAS BEEN Iii tSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN
DETERMINED TO PRESENTLY COMPLY WITH 1 SCHEDULE OF
REGULATIONS OF ME MIAMI SHORES LAND AND DEVELOPMENT
CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH
ONE- FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR
A ONE- FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS
CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR
WARRANTY AS TO THE CONDITION OF 1HE DWELLING OR OTHER
STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY
ASPECT OF SUCH CONDITION, AND INTERESTED PARTIES ARE
ADVISED AND ENCOURAGED TO MAID THEIR OWN INSPECTION
OF THE PREMISES IN ORDER TO DETERMLNE 1H�: CONDITION
THEREOF. •
•
•
•
7he FRANKLIN PRESS, 9i4c.
PRINTING • ENGRAVING • LITHOGRAPHING
STEEL DIE EMBOSSING • RULING • BINDING
928 to 996 S. W. TENTH ST.
PLENTY OF PARKING SPACE
PHONE 3 -8306
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X,, the undersigned, do 1 erst swear that the Stu is irk ado
i h 74 , issued to as gat'des at # tLn N E. lnnth "trAat.
Street address '
has been last„
(Da.c•
SIGNID AND SWORN TO BOORS Ma TAW . ,., . �., . ,.,t.. DAY OF
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?Totuy pub) i.s
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I hereby certify that the construction ConterQleted under
the above BOad has been completed and that the builder thereof has
caused the surrounding premises to be cleared aad repaired in as
good condition as they were before acma:enai*g said construction.
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THE LACKEY- SAUNDERS CO., INC,
Mr. William Otto
128 N. E. 22nd Street
Miami, Florida .
Dear Mr. Otto:
GENERAL INSURANCE
11 E. Queen St., Hampton, Va.
Sept. 21, 1949
I am enclosing the application for Building Permit. When I
wrote you last, I had not had it Notaried, so had to have
that done before enclosing it.
We did not put on our sketch the psition for the telephone.
We would like to have it on the 446ide corner of the bathroom
wall, as shown in the little sketch at the bottom of this .
letter. Also, could you move the light that is now on the
outside of the dining room door straight down so that it is
just above the step, and still in the wall where it will not
be something to stumble over.
We thought it might be necessary to run the conduit lines
for the telephone in before the work is finished.
We are hoping that you will find as you go along with the
work that you may be able to make savings here and there so
that when it is complete the final cost may be less than you
had estimated; however, we are leaving that to your good
judgment to do the best you can. Go ahead and get the work
under way as soon as possible, as we hope to come down some
time in the latter part of October, and hope it w 1 be com-
pleted when we get there.
Sincerely y
M. 0. Lackey
p. S. You fil. - any other blanks
in the Application
-Lt f kt post that may be necessary.
a bovc $t e.9
tN waLL .