BUILDING PERMITMIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement o► ►ne 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 . .......sk1Z1...;.,....]. �. �.TCla11.........._ _ No.�.�.2. »..».. Street N 101, St .
Registered Architect and /or Engineer , t ........ .,, »... ,.<..
Name and address of licensed contractor JOB —MIX Concrete Co . , PO Box 522310, Miami, F1.33152
w/ —»
Location and legal description of lot to be built on: f� J -&5 r' 9 0 0 7 -70 70 _
Lot 4 Block 177 Subdivision Miami Shores Section 8
Street and Number where work is to be done 1132 NE 101 St. y »»
State work to be done and purpose of building (by floors)
Replace broben concrete driveway
with a new concrete driveway i nstal a concrete entrance walk.
».. »_..._..__ and for no other purpose.
Ncw Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roo vering
'
2200.00 f..
Estimated Total cost of improvements Amount of Permit �i. : ...
Zone cubage required plan Cubage
Distance .to next nearest building. Size of Building Lot ... ► X 118
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
•
. H. Ted Sharp, JOB -MIX Concrete Co.
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 NVork►nen's Compensation Act, being Section 5 966, 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ..__._._ (Signed)
STATE OF FLORIDA, 1
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 fads
in by him stated + g��rt►e
Permit No G4. 1 Date ......... Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Notary Public, State of Florida
Building Inspector My Commiuion Expires
to me well known,
PLANNING BOARD DATE
Chairman Member
Member Member
Member ..... Member
Council Approved Date Disapproved Date
NOTE: A •ch.►rge of $1.00 will be made for making corrections or changes to this application nfter approval has been obtained from
the P1.►nnir.g Board.
A rein >pection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials anti /or workmanship.
do
N
123.03-94
BUILDING & ZONING - ADMINISTRATION
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PLOT PLAN
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NO SCALE
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ST., TCRR., AVE., CT., PL.
NOTE: 1. Show existing buildings and additions.
2. Show distance from property lines to buildings and /or new additions.
3. Locate septic tank or sewer and electrical service.
NORTH ARROW
Legal: Lot No. 4 Block No. / 77
Subdivision �amI 5J7Ctt SEC TWP. RGE
or
Metes & Bounds
Plat book and Page No. 4'3- d 7
ON
ON
)E - T P,t
C ALE : v = 20`
UPDATED
, FINAL
LOCATION SKETCH
A PORTION OF SEC. •S TWP 53% RGE
SCALE : = Soo'
K T H or SURVEY
- OF
LOT 4 , BLOCK 111
M‘AM1 s 4ORES
Seo*\om
µ•AM• 'MORE.°. VILLAGE., DAM co.
ACCORDING TO PLAT 800K 43 PAGE Gi OF THE
PUBLIC RECORDS OF O. COUNTY , FLORIDA
NOTES ALL RIGHTS OF WAY, EASEMENTS. SET BACK AND ZONING
INFORMATION MUST BE CONFIRMED BY ARCHITECT AND /OR OWNER
BASED UPON DESIGN USAGE
ELEVATIONS SHOWN THUSLY 9. ARE RELATIVE TO THE
NATIONAL GEODETIC VERTICAL DATUM OF 1929
CERTIFICATION
WE HEREBY CERTIFY THAT THE ATTACHED SKETCH OF SURVEY OF
THE ABOVE DESCRIBED PROPERTY IS TRUE AND CORRECT TO THE
BEST OF OUR KNOWLEDGE AND BELIEF AS RECENTLY SURVEYED
UNDER OUR DIRECTION.
DONAtO? W. Mc INTOSH ASSOC„ INC.
DANIEL C. FORTIN , VICE PRESIDENT
PROF LAND SURVEYOR No.2853
STATE OF FLORIDA
"NOT VALID UNLESS SEALED"
Prepared by
DONALD W. McINTOSH ASSOCIATES . INC
581 NE 91 et STREET MIAMI SNORES, FLORIDA 33138
SK. No.: CS S 2
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STATE OF FLORIDA,
COUNTY OF DADE. ss.
Disapproved ..It11 1�� ( ' Date.
(Signed)
MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement in um 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 budding during progress of the work.
1
Date---a.2.------------------- ... .. ,193
Owner's Name and Address .40.k.i.:)......... .. ► I I tM �d►�. _ _ No.1.1.30....... Street—L/
tr 1- .1'11..,..x......_.
Registered Architect and /or Engineer ,,,,, III' ... n,n,n.,„e „ . nos:
Name and address of licensed contttctor....R.i.C. r _ .. 0 ki..n. '.e ►\...34 9 s_...- .Q-)... ....C-.. -A -
Location and legal description of lot to be built on: .
Lot L {- Block..l..� 9 Subdivision 'I t4 "Vi .L 5�.Q✓ Li __ L I ( aj. ::Q....
/\ 1 � t
Street and Number where work is to be done 1..L C 11 ._.I 0 1 5 __ ...._._.�.
e.c.V.-s Cu) c..;
State work to be done and purpose of building (by floors). Q.
Building Inspector
BUILDING INSPECTION DEPARTMENT
Remarks (Signed)
and for no other purpose.
New Building Remodeling V Addition Repairs No. of Stories
To be constructed of .�...... ..." Kind of foundation L i ,k .e Ho y
Estimated Total cost of improvements $.. `G5`� , — Amount of Permit $. t6V
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 referenceto the building and its construction may
be sent to.. . R.' L \�.... O \ VA...5 An O t ... H . Cx . 0 Q V� �c.t..cc.......Y- ` — h.., I V G t t .
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of i.ibur under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup plcent;
and has complied with the provisions thereof, and will require similar compliance from all cpntr c rs or sub - contractors employe .by him
in the work to be performed under this permit; and will post or cause to be posted for ins 'cti the site of the work such-public notice
or noticcs as arc required by the Act. The undersigned agrees to employ only such su tr a, on w to be performed under this
permit, as are licensed by Miami Shores Village. f / i ) t
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/rue.. e.
Permit No. 3 , ,,< Date 3 i l v Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires __.._.
PLANNING BOARD DATE
Chaironan 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 Plarmir.;; 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 anti /or workmanship.