1170 NE 100 St (10)OWNER'S NAME
/'/9UL /(. NNEY
PRESENT ADDRESS
W.3 NE. W '.fr
ir L5.6.4:10.
PHONE NO.
7f-4W7
JOB LOCATION (ST. OR AVE.)
#764 &E. /OD-"
LOT
4
BLOCK
X7/
SUBDIVISION
4,0y#�oe45 c
&7► /
GENERAL CONTRACTOR I
J / i''//'N
ADDRESS
7/ A/0/ /o�. v.E
PHONE NO.
7-4-r/
LICE NSE jV
/3 .), ' ' *7
BUILDING PERMIT NO. � ' (
Q `
DATE // " / 7 V
PERMIT FEE S /7
BUILDER•S BOND
NO. DATE
n o
ZONE leCr REQUIREMENTS O, 471 CU. FT.
PLAN CUBE A45; "JO CU. FT.
EST. COST S gs:0,0 °
DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: C.` / '4-'
DATE
)<
NEW CONSTRUCTION
TYPE
��.5
STORIES
/
ROOF CONSTRUCTION !//e9AV INTERIOR � TERIIOR CONSTRUCTION
T - „ LET4DAC1 ON `eyc %iflJ
REPAIRS
DESCRIPTION
,!'•,41.-);/).,(/ .-, 6 ii. ..ko!/f /ID/ 3JF04YS- 2 &,Ni- y9e44,#7rip zo
ALTERATION
DESCR,PTION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
W Q
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
CERTIFICATE OF OCCUPANCY NO. 4 /v A
ISSUED 7 7 7
/'
. BY Ef(N �
//'� {
J TO .It /�,�ij/ /TG/ , /
BUILDING PERMIT AND INSPtCTION RECORD -MIAMI SHORES VILLAGE
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
/0/3/ 4
CMG
TEMPORARY SERVICE
FEE
TEMPORARY SERVICE
S
BEAMS & LINTELS
/314
et
sit!'
SEWER
S
RANGE CONN.
FRAMING
/ /
E!!/S
' MOTORS
$
GAS
S
FIXTURES
$
$
$
INSPECTIONS
FINAL
094/7
k/S
BY
RE- INSPECT
BY
ROUGHING
CLEAN -UP
TEMP. SERVICE
GAS
CONTRACTOR 1/4 /L4 -Co
PHONE
AA
PERMIT NO. L 1 9 1 DATE /Z / 4 , 4
FEE $ 9 +O
NEW BLDG. X 1 ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
FEE
TEMPORARY SERVICE
S
SEPTIC TANK ) Eh'O,C
4ra/4
094,7
sit!'
SEWER
S
RANGE CONN.
S
SOLAR HEATER
$
' MOTORS
$
GAS
S
FIXTURES
$
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
BY
TEMP. SERVICE
GAS
ROUGHING
0� /4/ y
Cam/
4 J5
SEWER
H. W. HEATER CONN
SEPTIC TANK
/
/it6/ +i7
Elir1
SOLAR HEATER
FIXTURES
,L jjj��,
7/7�/�,
GG ,,
,VS
,q
e�T
015-
CONTRACTOR 1 ,14// C 40 /'bR
PHONE 7:"S:24;"‘
PERMIT NO. #
'/ DATE / '1 4
FEE S /a 7 r
NEW BLDG. y
ALTERATION 1 ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
S
RANGE CONN.
$
' MOTORS
S
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE's- INSPECT
BY
TEMP. SERVICE
ROUGHING
0� /4/ y
Cam/
4 J5
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
,q
e�T
015-
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE 4_24/_ '/ BY f0.5
.-
$UILDING N DATE 194 &
ELECTRICAL PERMIT N? 4759 Contra tor � v 9 7
_ PLUMRNG -
Work to be performed under this Permit Y P IA/ Pev re /7 c 4
Owner of 4 v , / p.�
Building / /\ ' � `
Architect ce r 6' !- d P'
Contractor �"�j/ d or Builder �' / r 1 Q i' v 6 r>
Legal Lot 1 , Bl. j 7 7 Subdi
Descriptio �'T vision
•
:;::—
ddef 1 rr �� R j Value of . e . C � Amt. of l
0 ' /1 o' f V �} Project �� Pe rmit
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 -thejeto and w th the understanding that the work wil 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 ass mes respon-
sibility for work done by his agents, servants or e .loyees. • , (" kr
�
Signed. C t 4 . ., / { e By y' ' ?•
III INSPECTOR t
In onsideration of the issuance to me o' this p it I agree to perform the work covered here in compliance with nances avid' 1 tens
pert Tither to nd in strict ' o . e r mity with the t ns, drawings, statements or specifications submitted to the proper authon f Miami Shorlage.
ncce s'permi I . = esponsibility for a ork done by either myself, i y agent, servant or employee. .
t,
CONTRAC'lQR"OR BUIL
MIAMI SHORES VILLAGE, FLORIDA
BY AUTHORITY
WILDING
LECTRICAL
PLUMBING
Jwner of
3uilding
o
CONTRACTOR''CR BUIL
MIAMI SHORES VILLAGE, FLORIDA 47/
DATE ' 194
PERMIT N? 4759
Contractor's
License No
u
Work to be performed under this Permit M 1 A/ /' eJ /C fb /'a c' -'
PO V / A / hi e 7
Architect 9 er r 6 - S /,
: ontractor C` �., „.
m. Builder " ' k
.ega1 Lot BI. Subdi-
)escription vision
Address of J4 / +r Value of iq
3uilding li / Cr `' /1 6 Project
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-
ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work wil be performed in compliance with any
:fans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
it 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
iermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
° egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assujnes respon-
sibility for work done by his agents, servants or employees. < , (
Signed.
INSPECTOR
By
In considera on of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances an regulations
iertaining there d in strict s •rmity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
n acce ass esponsibility for all work done by either myself, my agent, servant or employee.
Aint. of
Permit
1 •
f
BY AUTHORITY
L% e 0
yock
lei) e
Owner� e
dd 0/
General �� 9ontractor Lic.No• Add. or Phone
Zone Req.Cu.Ft Cu. Cont ^ fs y d By GI K„ ,, (
. �A Q � � (� . �!�, �,
Plat Restriction Checked by C //
To Planning Board 6Y/4 Approved V Rejected
Re- Submitted to P.B. Approved Rejected
Plans & Spec. Checked by
To Council
Subdivision
c,4,e
Approved
Bldg. Permit No. Date %� ee
Type • C. 0 i Stories
New Construction
Plumbing Permit No.
Septic Tank
Sewer
Misc rl
New Cons t .
Electrical Permit No.
Fixtures
Heater
Motors
Miser].
New Construction
Building Inspection
Foundation
Beams & Lintels
Final
Final Clean -Up
Dato
0
Lic.No. Add. or Phone
Roof
Alterations Repairs
rr
Alteration
rr
rr
rr
Repairs
No. Street
//7d Mk /do f7'
Rejected
Cost / '
Date Fee
rr n
n ►r
It 11
Alteration Repairs
Date
It / Fe e D (""
rr
By Re -insp By Re -Insp By
Plumbing Inspection Date By Re -insp By Re-Insp By
Roughing
Fixtures
Sewer
Septic Tank / 1/7
Solar Heater
Final Certificate
Electrical Inspection Date By Re -insp By Re -Insp By
Roughing 0 2 Viz,,,)
Fixtures
Final
Temp. O.K.
Service O.K. to Power Co. Cert.Occup.Issued
e-r A c.
F G P• �/�
c� ^� � PAID BY
Y EAR
N.
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
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a 4 is s,
5 . 0 o
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ADDRESS /0 7
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LEGAL
M. 69-A1 ,S' Res S''eC•
�L D�� RECORD GARBAGE TA
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
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legs description of lot to be built on:
Lot Block t/
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
,x
_� — and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories,_
To be constructed of t ��i Kind of foundation 4 ,�'i ( 1 '�' ,P R oof Covering r � /
improvements �� v
Estimated Total cost of im
p $___,� �,_�2___C G Amount of Permit $ /
c
Zone cubage required L ^-* C � ' r �� _Plan Cubage � c.,1� •'
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 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, on work to be performed under this
permit, as are licensed by Miami Shores Village. j
Remarks (Signed) eil r
STATE OF FLORIDA, 1
COUNTY OF DADE. i 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 carefu ly read the foregoing application, and that he did sign the same, and that all facts
therein by him state are true.
Permit No °" Date % c � Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Building Inspector
PLANNING BOAR
BUILDING INSPECTION DEPARTMENT
Date
No Street
AT
1 J " ,19
Notary Public, State of Florida
My Commission Expires
ChairmaC2e1' 1.4" - / Member
Member?? , — __ �__ _ pcQol 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 suclj re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.