1217 NE 100 St (8)• OWNEP S NAME
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f1 (� PRESENT 1 ADDRESS
9999 I T.E. 121.1h. L.vc
LICENtiE NO. i PHONE NO.
JOB LOCATION (ST. OR AVE.)
1: % a1 . : :. . . 1.. - I:_ ,. ■. ...t
LOT
2
BLOCK
5
SUBDIVISION
tiar1'cc..1 :1I - - :.:s
GENERAL CONTRACTOR
- • -- • ,,... ; : ': ,.' . .:31 I:::'.
ADDRESS
1050 iI..... 153r0 . ...trooi
PHONE NO.
BUILDER'S
NO. ;,n;;;, DATE
LICENSE NO.
1G2.
BOND
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n
BUILDING PERMIT NO. 4322
DATE 9- 13 -5':
PERMIT FEE $ 2 ^.0r,
ZONE- REQUIREMENTS 25000 CU. FT.
PLAN CUBE 25'-'0'.7. c.C.' CU. FT.
EST. COST S 1 - - -� -
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: 2/.1'. 1 <ar::C1
DATE
9-13 -5
NEW CONSTRUCTION
TYPE
j U ,-',
. -
STORIES
CM'.
ROOF CONSTRUCTION
!;l
A �.1.0
INTERIOR CONSTRUCTION
n 2 '- ) 2 {1.:: 2:
L4: L.
REPAIRS
DESCRIPTION
` �%d , ..• Z - :.r $ Or C7 -:;%:i C.:' 1 . �, t .1.....;.12L f 1; 1 P.S'G(.rC'.. TT%1.1_S P: C:.. - 1_:15
ALTERATION
I DESCRIPTION
:.:1c 5:.1.1.5, it ;._ "SC.
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
/ q ?
CERTIFICATE OF OCCUPANCY NO.
I / -30.. sz,
ISSUED
ca)
BY
cr r. ,..) . S A�,s e tn2
TO
BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE
INSPECTIONS
DATE
I
PERMIT NO. 'DATE -
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
..
TEMPORARY SERVICE
,
$
SEPTIC TANK 1 c_% <
•S�
BEAMS & LINTELS f-
z J ��<-
K-
7
•�(4
- SF
$
SOLAR HEATER
FRAMING /c.
3(.
GAS
-. !,� �
-u� 2_
$
INSPECTIONS
DATE
BY
$
INSPECTIONS DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FINAL
. .
��c: K `
ROUGHING
GAS I
c -- - ^(
�..� ^r
CLEAN -UP
SEWER
•
CONTRACTOR `
HONE
I
PERMIT NO. 'DATE -
EE $
{
NEW BLDG. IALTERATION ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
SEPTIC TANK 1 c_% <
•S�
$
SEWER
$
SOLAR HEATER
5
GAS
$
INSPECTIONS
DATE
BY
$
INSPECTIONS DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
:: i
ROUGHING i..- -..S L. _
. .
��c: K `
ROUGHING
GAS I
c -- - ^(
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SEWER
SEPTIC TANK }i_ ? % .- .--_
c -e,
Z. 3 i,
SOLAR HEATER
FIXTURES c
FIXTURES & FINAL I
PERMIT NO. - "r — 'DATE ! - - -" - - f EE S _%:' — -
NEW BLDG. ::;.t. 1 ALTERATION ADDITION IR PAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE 4' ••
-
$ ! ' ..; af .7
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
S
FIXTURES
S
$
INSPECTIONS
DATE
BY
RE-INSPECT
BY
RE-INSPECT
BY
TEMP. SERVICE
ROUGHING
c -- - ^(
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H. W. HEATER CONN.
RANGE CONN.
FIXTURES & FINAL I
49�
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
CONTRACTOR
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE
PHONE
BY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building l r'
Architect t .- , / f
Contractor
or Builder ! -1
Legal Lot
Description
Address of
Building f R
0 DCDIuIT N° 4222
la
0 pas Work to
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
Value of
Project $ f V
DATF
195
Amount of
Permit $
L
This permit is granted to the contractor or builder named above to construc 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.
Signed. r ! cr' - "BY
INSPECTOR
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, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY ems.
STATE OF FLORIDA,
COUNTY OF DADE. f ss
b
Permit No _ - _ Date
Disapproved Date,.
(Signed) , __ _ l
Building In ctor
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
s /l
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.
Date / // ' , 19
Street /
Owner's Name and Address ' / -'
Registered Architect and /or Engineer
Name and address of licensed contractor ' ,
Location and legal description of lot to be built on:
Lot Block Subdivision 2 , " i. e -
Street and Number where work is to be done / / 7 /` ' ' --
State work to be done and purpose of building (by floors) 1;:. `
•
Read, Sworn to and Subscribed before me.
0._
and for no other purpose.
New Building - Remodeling Addition Repairs No. of Stories •
To be constructed,of Kind of foundation e- ^' e. .1 • ' Roof Covering • / ' •'
Estimated Total cost of improvements $ / ....53(.g b' Amount of Permit $ Z r Cl T3
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
The undersigned applicant for this building pennit 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 subcoptractArs, on ;work to be performed under this
pennit, as are licensed by Miami Shores Village. ) _; ;'
Remarks (Signed �s� '� . 1 i� /I) l % %��.
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.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chainnan 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.
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Lot 2, block 5, Eft drOli SHORES, aocardin,; to t.ie plat thereof recorded
I:. ?lat 6oca 43, at page 80, of the Public Records of Dade County, Florida �
July 9, 156
Soales Shove
. K3 1:i 3t: That the attached 01 A■f" ax' tae 61Uilve des -
:.rloed ;rope rty is true and correct to the beet of my cdiowledge and belief
as recently surveyed and platted udor my direction.
La3JJI T 3T)
H. M. , 1 JL3 RT , Regis tared Land
ST. OF FLORIDA
Surveyor #869
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