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1217 NE 100 St (9)MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT. 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 Divisinn 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..._.../ —b-P . ._._.._.._— _......_._.......... ,19..L..C Owner's Name and Address /Vie v t.i!.r 4.. ._ No.. iii- 1 7 _ sae et_...F" T ... ..L a7 Registered Architect and /or Engineer 01,11,1!,/ ,.M._.• Name and address of licensed contractor L 5 �C' /- e vee go 1 t ... Location and legal description of lot to be built on: Lot / Block Street and Number where work is to be done /sa?.L7 /v E / .'Oi � / J State woe to be done and purpose of building (by floors).. r 'eC �3 y a ._.. _ s ...__._ Cyf% t rs�_ _ _ f -a izi and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering p Estimated Total cost of improvements $ G ( tl U ° . /.a e Amount of Permit $. 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 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 La .f Florida, Permanent Sip,Iement, and has complied with the provisions thereof, and will require similar compliance from all contract • s o sub - contractors Employe by him in the work to be performed under this permit; and will post or cause to be posted for i sp ction • th ite of the wor uch public notice or notices as are required by the Act. The undersigned agrees to employ only such tor., o• r ork to be • formed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss Permit No.. ._ _ r Date Disapproved .. (Signed) Date Subdivision in2.kellf mil/ - * 6_4 9 gel: 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 forgoing application, and that he did sign the same, and that all facts therein by him stater, amt-7,--' �� I �� Cyr `�-- Z Chairman \Icrr.bcr Member ...... Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLA NC BOARD DATE Member Member Member to me well known, 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 fce of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT. APPLICATION FOR BUILDING PERMIT Application is hereby wade 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. Ov:nei s Name and Address . / Registered Architect and /or Engiineer..... ,.,....1...,112 1.7..11. Name and address of licensed contactor Crl��fS ? t.. K �C _ � . /7/a/ (r y Location and legal description of lot to be built on: i✓' �K:S� �" ^ . Lot C?"-. Block � Subdivisi Street and Number where work is to be done...........( P(J a 100 .--. /t? fit° State work to be done and purpose of building (by floors) rf. and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of - / p/te6 -S Kind of foundation Roof Estimated Total cost of improvements $ 6 , Amount of Permit $. 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 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 contractor 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 • ' th site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sus • •r , o. work to be perf• ed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, 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 facts therein by him state are true. ' G Permit No. __.___._.. Dat ( 7 Read, Sworn to and Subscribed before me. Disapproved � D ie._ _...._..._._... f ,� J V �• Notary Public, State of Florida (Signed) Building ff nsj for / My Commission Expires f/ Date — )2 2? _�_ ,19. Ti _ No . / ... Street._ Lv t ..00; !_ PLANNING BOARD DATE to me well known, Chairman Member Mernbcr Member Member 1111.. - -- ..._..._.._....-- .• -. -- 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 frrnn the Planning Board. A re - inspection fee of 31.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty materials anti /or workmanship. I taiCE A/ Sao sr BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA Date 19 o ELECTRICAL ❑ PLUMBING ❑ PERMIT N? 10717 Contractor's . "- License No. ROO ING ❑ ❑ Work to be performed under this Permit t t 1 r a 4 -, Owne. of Building J• ... t....- ..- f -. . . f. e Architect Contractor s or Builder 4-.-- t ' + ` Legal Lot Description II B1 i . Address of L 1 Building CONTRACTOR or BUILDER 90/ Subdi- vision Sq. Ft. Value of - e 1 11 Amount of Project $ 11 Permit $ 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 applica- tion 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 whet shown on thy,,plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, sery is or emplo s. Signed • SPECTOR) BY In consideration of the issuance to me of this permit I agree to Alorm the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, stgtelfients or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by,Either, myself, my agent, servant or employee. • -..1 BY AUTHORITY MIAMI SHORES VILLAGE Owner's Name and Address E� =i�� Registered Architect and /or gineer. BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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. Name and address of licensed contractor_ _e1/L -_ Location and legal description of lot to be bui}t on: Lot 02 Block Street and Number where work is to be done__ State work to be done and purpose of building (by floors)_19? ( Subdivision Date - ,� i�lr. -_ '" . ,19._ 6P No.___ (__aL /7 Street__ / QQ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $... 11 r a d Amount of Permit $ 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 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 5968, Compiled Gener aws of Florida, Pennanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all con.. tors or sub -con: actors employed by him in the work to be performed under this permit; and will post or cause to be posted for 'ns.ec . on the site of t e work such public notice or notices as are required by the Act. The undersigned agrees to employ only such s '.. • rs, on work t • be performed under this permit, as are licensed by Miami Shores Village. Remarks ( Signed ) _ STATE OF FLORIDA, COUNTY OF DADE. 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 carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. g� Permit No.________1 t ? Date_ . 2�� t" 4 Read, Sworn to and Subscribed before me. Disapproved a ate f Notary Public, State of Florida (Signed) " �► Building Spector My Commission Expires PLANNIN BOARD 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. J /IL o J, 01 7 1/,