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1150 NE 100 St (4)T OWNER'S NAME PRESENT ADDRESS LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) BLOCK SUBDIVISION efk 6r G RAL CONTRACTOR �� l , A/N� r ADDRESS Off .f3 /e. PHONE NO. 78 il387 LICENSE NO. BUILDING PERMIT NO. 1 DATE �� Ocs PERMIT FEES 19 BUILDER'S BOND NO. DATE ZONE ,e-, REQUIREMENTS /0, a CU. FT. PLAN CUBE J4/ 947 CU. FT. EST. COST S /� 40 Q DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: C.L. . DATE X TYPE • ` NEW CONSTRUCTION S C.5v STORES /, I ROOF CONSTRUCTION " ' TLE INTERIOR CONSTRUCTION A. REPAIRS /201•25: DESCR IPTION ��� .,' / 7;:zEDNIOM(. h , sr„&cemfteCyOyfil.C?^ ALTERATION on if. " /�� p p , DESCRI = PTION ` �' o" `d� !/. Q/N�c/7 /Di«y -3.110 ✓ 4r / - !✓.!x!/. /O/Lif7 = 2-6,,2 Ae'wie .P ADDITION SUBMITTED TO PLANNING BOARD APPROVED t/ /f4e REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD !! SUBMITTED TO VILLAGE COUNCIL REMARKS 3 CERTIFICATE OF OCCUPANCY NO. 4 ISSUED , C BY �"' � ✓ T /�f � p per TO �/• �.• /CILf/v/v// / BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION - PERMIT NO. DATE FEE TEMPORARY SERVICE $ BEAMS & LINTELS SEPTIC TANK $ $ SEWER FRAMING $ SOLAR HEATER $ $ GAS $ $ S $ FINAL DATE BY RE•INSPECT BY RE- INSPECT BY CLEAN -UP ROUGHING CONTRACTOR PHONE PERMIT NO. I DATE FEE $ NEW BLDG. 1 ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ $ SEPTIC TANK $ $ SEWER S $ SOLAR HEATER $ $ GAS $ $ S $ INSPECTIONS DATE BY RE•INSPECT BY RE- INSPECT BY ROUGHING ROUGHING GAS H. W. HEATER CONN. SEWER RANG.. CONN. SEPTIC TANK SOLAR HEATER FIXTURES & FINAL FIXTURES CONTRACTOR PHONE PERMIT NO. DATE FEE $ NEW BLDG. I ALTERATION 1 ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. S MOTORS $ FIXTURES $ S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN. RANG.. CONN. FIXTURES & FINAL BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE BY BUILDING ELECTRICAL PLUMBING • Owner of Building Lot V Architect Contractor or Builder Legal Description Address of �+ { ( Value of r •-. • { Amt. of +►y Building 4 Q ` j ' / C ' '+ P / ,• , r e "'" Permit �f This permit is granted to the contractor or builder named above to cons truct the building or to install the equipment or device described the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in complia ce with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Pern 't m 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 conditio on 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. , ," • Signed: (se .. rs r INSPECTOR /j ; i By e ' In consideration of the issuance to me of this permit 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining the to and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting its permit I as,.., u 1, p,n for all work done by either myself, my agent, servant or employee. �/" .d' CONTR CTOR BUILDER BY AUTHORITY PERMIT N° `' 4363 Work to be performed under this Permit / Y i ¢ ! J r el ' MIAMI SHORES VILLAGE, FLORIDA DATE Bl.: r Subdi- vision Contractor's License No 194 1( 77 ti JIUI!pING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description ACTOR 1 Per / f\ / /2 is e /r/. (, / v e i Lot Bl. / Subdi- j vision ` IP B i ld i ns of f f { l Y (*1 ' Value Project of g 9 c) "'.,� Amt. , 7 ,~ 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 appli- cation 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. /''' Signed. `�.. t 4,e /� • By / INSPECTOR , In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance withog,prdinances nd regulations �u ng t pertah- eto and in strict co ormity with the plans, drawings, statements or specifications submitted to the proper authoftittibbss of Miam' h6res- Village. In j6cepting 4 is permit I ass -sponsibility for all work done by either myself, my agent, servant or employee. u MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 4363 Work to be performed under this Permit BUILDER int±9 BY M w DATE Contractor's License No. 3/p, 0 AUTHORITY 194 /6 -7 BUILDING ELECTRICAL PLUMBING Architect Contractor or, Builder ' Description CONTRACTOR O R BUILDER . h o. MIAMI SHORES VILLAGE, FLORIDA DATE "At . oil 194 C Contractor's License No. /e 9' A PERMIT N° 4720 Work to be performed under this Permit Owner of • Building Subdi- vision BY -44 Address of / Value of ' Amt. of • . „ow f'uilding Project Permit o gr e 6ss ! - This permit is granted to the contractor or buildernamedaabove to construct the building dr to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 an 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 th tatei ts or specifications and that he assumes respon . sibility for work done by his agents, servants or employees. Signed j . V* By _ N ECTOR _ In consideration of;the issuance to me of this permit I agree to perform the work covered hereunder in compliance with pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper auth In acce.ting this permit I.assume responsibility for all work done by either myself, my agent, servant or employee. 44, ordinances and regulatgons MA of Miarni Slrols llJge. ,AUTHORITY ADDRESS - 1150 NE 100th St LEGAL Lot b ts1K J.10 maffo RECORD GARBAGE TAX PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER - J C Kilburn / 9-1747 . , -3 _ . / -- 0 -.. , .. , at n /2. O d (2 .?/-9 U " \ 12 y? /0c3 ,, /fqf /.; ' ,_3--t / /L'-Y ,, „ // /9s /4 S / /ff6 / /.S D /- -, '' / • _ / ,' .? •,3 .5/ - i% . ,, • / 9:6 - vx " /t - 3 /'S / A•00 // - ,t - .6 / ei.,/ .4 f // 7ef Ae Lo t Block Al Own r' s� flan '7 Name Lic •No. /( 17 Add, or Phone K " Genera Contractor Lic.o• Add. or Phone By CA Zone Req.Cu.Ft. di,' 4 'd Plat Restriction Checked by To Planning Board 5 ///b4 Approved Rejected Re- Submitted to P.B. Approved Rejected Plans & Spec. Checked by To Council Rejected Bldg. Permit No. Date, 4 Fee Cost / �4 Roof Type el Stories New Construction Alterations Plumb ng Permit No. Date Septic Tank 11 Sewer Misc'1 New Const. ,Alteration Electrical Permit No. L/ c/ , Date Fixtures Ir Heater' Motors Misc'l New Construction Repairs Building , Inspection Y Data By Re-insp By Re -Insp By . Foundation �_; X' L el, J; Beams & Lintels ' { r,/ g, Final Final Clean-Up Plumbing Inspection Date, By Re -insp . By Re -Insp By Roughing /. Fixtures Sewer Septic Tank Solar Heater Final Certificate Electrical inspection Roughing Fixtures Final ,3,ervice O.K. to Power Co. Alteration fi y e -ins p 16 Subdivision 4 e 7 l< 9/1 11 11 11 11 11- Cu.Cont. (y e Approved /9 /V/ N!D. Street Repairs Fee 11 • 11 n 11 Ir Repairs V Fee // 11 By Re -Insp By CerteOccup.Issued 2 /mot /q7 MIAMI SHORES VILLAGE 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. /(e Vate____ lCL< `. — , 19___ (� Owner's Name and Address____ i ( � NN _ // No.1/49 0 4' Street__lvG _ //S Registered Architect and /or Engineer__ a l P/ Ii Name and address of licensed contractor ___ _Y__ Lt.J y _ 7 <Fo Q N _&___/__P_ Afite._1 44te rC 0 - '8) Location and legal description of lot to be / built on: 1 ' Lot Z Block 78 Subdivision_____1L_, -5 e._ -____ Street and Number where work is to be done /03 _ 4_!,_. • /) 0 3 7 _ Stat , work to be done and purpose of building (by floors)___.a_t!J_L ? fr. a Ct% O /11 C2/ e- 5 eliide P ..Ari ea zzy_9 p e!!_V�-Q __ _e / and for no other purpose. New Building e 5 • Remodeling Addition Repairs No. of Stories .2- — • To be constructed of___ ." Kind of foundation 11 11Y.6 rate Roof Covering. fE Estimated Total cost of improvements $ Amount of Permit $ __ 7 ______ ___ _____ __ Zone cubage required / j7c 0 _Plan Cubage _V_ .2 .1 a c Distance to next nearest building 2D Size of Building Lot -7 4 / / ,9 Maximum live load to be borne by each floor I hereby submit all / tt y h �' e plans and specifications for said building. All notices with / reference to the building and its construction may, _ �l be sent to___ ,___4(__ar i f itit / _4__ ,44,__ - - -I ' 4v l! 4 M.; 6 c) E! / Q1_ 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 subcontractor on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) _(- 4 BUILDING INSPECTION DEPARTMENT PLANNING BOARD STATE OF FLORIDA, COUNTY OF DADE. c ss. Before me, the undersigned authitY a notary . .lic, d ly : uthorized to administer oaths and take acknowledgments, personally ap- peared 64 - ------ ----- -- - - -- 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 state true. ' Permit No f Date / tda Rea orn t an. Subse ' xne. . Disapproved Date- — ---,- Notary Public, S Florida �� � ,_J ? Building di Commission Expires____ (Signed) 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.