OCCUPANCYLot
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
N° 130
Owner, Agent or Tenant of Building
Street Address
Block
Miami Shores Village, Florida,
Subdivision
I; -. ,1 /p/ w ., 4
L
3- 2,3-6°S"
Approved use by occupancy
Remarks.
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, al ration or remodeling of buildings or structures.
BUILDING DIVISION
•
OWNER'S NAME
Dr. Melvin Klotz
PRESENT ADDRESS
LICENSE NO.
PHONE NO
j
JOB LOCATION (ST. OR AVE.)
Harry Schwebke 4 _�' •
LOT
2
BLOCK
1
SUBDIVISION • .. p
Gordon Shores
GENERAL CONTRACTOR
owner
ADDRESS
PHONE NO.
LICENSE NO.
54
9-11-54 "
BUILDING PERMIT NO.
9 5
DATE 11 -2 " -54
PERMIT FEE $ 23
BUILDER'S BOND
NO. 1735 DATE
ZONE REQUIREMENTS CU. FT.
PLAN CUBE 25,044 CU. FT.
EST. COST $ 19,000
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY
DATE
NEW CONSTRUCTION
TYPE
cbs
STORIES
1
ROOF CONSTRUCTION
tile
INTERIOR CONSTRUCTION
tt Ti 7. ?n f nnrc _ n aat.ar tan e
REPAIRS
DESCRIPTION
and ceilings
3 bdrm. -22- baths - living room- dinine room - kitchen - screen nnrrsh pnrAFP.
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
• REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
CERTIFICATE OF OCCUPANCY NO. 1 1b
''{�
ISSUED 3• 1
A
BY
i' �� ff
TO ''1,.. - 4,...
ALTERATION
DESCRIPTION
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
INSPECTIONS I
DATE
PERMIT NO. 1 DATE
, ` BY RE- INSPECT BY 1 RE- INSPECT
BY
FOUNDATION
-
SPECIAL PERMITS
t
DATE
FEE
TEMPORARY SERVICE
BEAMS & LINTELS
$
SEPTIC TANK
MOTORS
S
SEWER
FRAMING
FIXTURES
$
SOLAR HEATER
$
$
GAS
$
INSPECTIONS
$
'/, `
ti
By
$ ____
INSPECTIONS DATE
BY
RE- INSPECT
FINAL
'�
rz_ -
t ',
,
p• 4,4
ROUGHING
>
'
CLEAN -UP
H. W. HEATER CONN
SEWER
CONTRACTOR
PHONE
PERMIT NO. 1 DATE
FEE $
NEW BLDG.
ALTERATION
ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
SEPTIC TANK
MOTORS
S
SEWER
$
FIXTURES
$
SOLAR HEATER
$
$
GAS
$
INSPECTIONS
$
'/, `
ti
By
$ ____
INSPECTIONS DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
ROUGHING
>
'
GAS
H. W. HEATER CONN
SEWER
SEPTIC TANK 2' p( ) is
A J
SOLAR HEATER
FIXTURES
_,, L I
----
FIXTURES & FINAL
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
S
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
By
RE- INSPECT
BY
TEMP. SERVICE
'
...- - .y' } ,
w ; J-
/ 3- ti
.-
ROUGHING
>
'
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
CONTRACTOR
PERMIT NO.
NEW BLDG.
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
ELECTRICAL PERMITS & INSPECTIONS
DATE
1 ALTERATION ADDITION
APPROVAL TO POWER CO. FOR SERVICE DATE
PHONE
FEE S / z
REPAIRS
MY
Owner's Name and Address.
Registered Architect and /or Engineer
Name and address of licensed contractor
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT Aci — f ®Q
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted or th p b uiid-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinafice o 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.
Location and legal description of lot to be built on:
Lot Block Subdivision s
r„
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Street and Number where work is to be done 1z._.5 49
State work to be done and purpose of building (by floors)
Date 17 , 19
No Street
and for no other purpose.
New Building � Remodeling Addition Repairs. No. of Stories
To be constructed of - Kind of foundation R oof e r'
Amount of Perm' A
_Plan Cubage r� (1
Estimated Total cost of improvements $
Zone cubage required 2,__5 0 c e,
Distance to next nearest building. Size of Building Lot
Maximum live load to be borne by each floor
Notary Public, State of Florida
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 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) __.., Alf sc"
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.
Permit No � x _._. \ .. , .,., Date ��` y Read, Sworn to and Subscribed before me.
y
Disapproved ` ..L' ' Date
(Signed)
pector My Commission Expires
PLANNING BOARD DATE
Chairnan V Member
Member Member
Member Member
Ccuncil 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Legal Description:
Comments:
APPLICATION FOR CERTIFICATE OF RE OCCUPANCY
I, , hereby apply for a certificate
to re- occupy the single family residence known as : (address)
/01 - , Miami Shores, Florida.
Lot: Block PB & PG:
I hereby certify that I understand that the zoning of the property is for single- family residential use
and that it is unlawful for more than one family to reside therein. I also understand that any
Certificate of Re= Occupancy that may be issued by Miami Shores Village, certifies only that the
referenced property is being used for single-family purposes and that such Certificate does not
constitute any representation, warranty or certification as to the condition of the dwelling or other
structures on such property.
Applicant Date 2/2
Print Name
*************************************:= x******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
For purposes of conducting the inspection required by Section 902 of the Miarni Shores Land
Development and Zoning Code, please contact:
Contact Name: /��i' /Telephone:
Buyer Seller Realtor Company Name
Application Fee (SS0) paid: Cash
PAGE I OF 2
Check No. / S�S
pproved L Denied Date
CER11k1CATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the property
described in the above application has been inspected for purposes of re- occupancy pursuant to
Sections 901 and 902 of the Miami Shores Land Development and Zoning Code and that such
property may be re- occupied by the above applicant for single- family residential purposes.
PAGE 2 OF 2
MIAMI SHORES VILLAGE, FLORIDA
By
Date of Certification.
THIS CER'1 LhICATE VERIFIES THAT THE REFERENCED
PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES
VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY
COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE
MIAMI SHORES LAND AND DEVELOPMENT CODE
PERTAINING SOLELY TO THE REQUIREMENT THAT EACH
ONE-FAMILY DWELLING IS USED AND INTENDED TO BE
USED FOR A ONE- FAMILY DWELLING PURPOSE ONLY;
HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY
REPRESENTATION OR WARRANTY AS TO THE CONDITION
OF THE DWELLING OR OTHER STRUCTURES ON THE
PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH
CONDITION, AND INTERES' PERSONS ARE ADVISED AND
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE
PREMISES IN ORDER TO DETERME E THE CONDITION,
THEREOF.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder ' 1
Legal Lot
Description II B1
MIAMI SHORES VILLAGE, FLORIDA
DATE t 19
PERMIT 4912 Contractor s
License No.
Address of is F
Building
CONTRACTOR OR BUILDER
Value of
Project $
Subdi-
vision
Amount of
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 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. f 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
AYROT
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._
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
K
Date
No / O
19 �J
oz Sr,
Street..,__
Registered Architect and /or Engineer
Name and address of licensed contractor ‘e tlt= ®l� e!{�.D._l!d� �__: ��• d rR_C?_�__ �� � r
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done / 2 ® / / /.aJ ' ti
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering__ _F/ Z l R41/ L.
Estimated Total cost of improvements $_._l d_2 5" 625. "°' 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 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,
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 /14 / Date fl ' 2,5--,,c3 Read, Sworn to and Subscribed before me.
Disapproved _ Date Notary Public, State of Florida
(Signed)
Buildig! Inspector My Commission Expires
PLANNING 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 Ph ning Board.
Are- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
m erials and /or workmanship.
THIS LICENSE MUST BE DISPLAYED IN A CONSPICUOUS PLACE
A PENALTY IS IMPOSED FOR FAILURE TO KEEP THIS LICENSE EXHIBITED AT YOUR ESTABLISHMENT OR PLACE OF BUSINESS
Village
THIS LICENSE EXPIRES M8y Xt, 1955 19
In consideration of the sum of
}IL:criy..fiva tin ...1 =Via Dollars ($250 )
Paid to Miami Shores Village, Dade County, State of Florida,
ir. LittlS,i n J VW
**Mu it 'K'4*
License
1230 I'31gt ;tr- e'C
N° 442
is hereby licensed to engage in or operate the business of O+mbuilivo
expire/ oft m tres tint" of 1 afriAf is
MIAMI SHORES VILLAGE, FLORIDA
: �rsr ?9, 1454
Date Issued By
THIS LICENSE NOT TRANSFERABLE WITHOUT THE APPROVAL OF THE VILLAGE MANAGER.
MSV 1984
KIND OF POLICY
POLICY NO.
POLICY
PERIOD
LIMITS OF LIABILITY
Bodily Injury
Property Damage
Workmen's
Compensation
wC2 5 033
Eff. 11/22/5'
Exp. 4/1/55
Statutory
Nil
Manufacturers' and
Contractors' Liability
MP L 74432
Eff. 11/22/5 •
(
Exp.4 / /55
Each person $
Each accident $
Each accident $
Aggregate $
Owners', Landlords'
and Tenants' Liability
Eff.
Exp.
Each person $
Each accident $
Each accident $
Owners' or Contractors'
Protective Liability
Eff.
Exp.
Each person $
Each accident $
Each accident $
Aggregate $
Automobile
Liability
Eff.
Exp.
Each person $
Each accident $
Each accident $
Comprehensive
General Liability
Eff.
Exp.
Each person $
Each accident $
Aggregate $
Each accident $
Aggregate $
Comprehensive
Automobile
Liability
Eff.
Exp.
Each person $
Each accident $
Each accident $
BITUMINOUS FIRE AND MARINE INSURANCE COMPANY
HOME OFFICE • ROCK ISLAND, ILLINOIS
CERTIFICATE OF INSURANCE
THIS IS TO CERTIFY that the described policies, covering in accordance with the terms thereof, are in force as of the date hereof:
Insured DR. MELV I N M. KLOTZ AND JEWEL KLOTZ
Address 1147 IOFTH STREET — BAY HARRAR — FLORIDA
Location covered 11 1 4-7 IOOTH ST. t BAY HARBOR & 1250 N. E. 101 T ST., MIAMI SHOES, F(.A.
This certificate is issued to
Address MI AMI SHORES — FLORIDA
Insuring company designated by "
Dated NOVEMBER 24TH, 1954
Form P334a -7 -53
BITUMINOUS CASUALTY CORPORATION
In the event of any material change in said policies, the insuring company will notify the party to whom this cer-
tificate is issued and in the event of cancellation thereof, ten (10) days prior notice of such cancellation will be given.
BY REGISTERED MAIL
VILLAGE OF MIAMI SHORES
® BITUMINOUS CASUALTY CORPORATION
❑ BITUMINOU FIRE A D MARINE INSURANCE COMPANY
THE MIAMI t\G'EISTH OR e RESENTATIVE
6g2 N.E. I24TH r oc Ta Nn MIAMI FLA.
By
STATE OF FLORIDA) SS
COUNTY OF DATE )
) r 4 1. of the Village of'Miamt,,jhores,
County of Dade and St e of Florida, being duly sworn, doth depose and saw,
that under the provisions of Ordinance No, 185,, dated June 15, 1948, amend
ing paragraph ( of Section 2 -368 of Ordinance No. 97 of the Building Code
of Miami Shores Village, he desires to build a 4F -r"
on Lot 2 Block / of Goifoa Slie let Subdivision,
that he is the owner of said property, and will be the owner of said
IF S (O,E,dCrF , that he will do the work perss pally, and that .
he will, at such times as are required by the Zoning and Building Director: -
1. File plans and specifications and obtain approval of the
Planning Board and the Building Inspector.
3. Pay the required fees.
And Further this Deponent says not:
A F F I D A V I T
2. Apply for and secure a Permit.
4, Execute the work in accordance with the provisions of this
Code.
5. Apply for inspections.
6, File with the Building Inspector certificates that provision
has been,made to carry the necessary Workmen's Compensation,
Public Liability and Property Damage Insurance.
7. File with the Building Inspector as the job progresses certi.
ficatee showing the payment required by the Federal Social
Security Act to the State of Florida or the United States of
America.
8. Assume the responsibility of not employing other than properly
licensed contractors by Miami Shores Village for any part or
portion of the work.
9. Not set himself up as a "contractor ".
10. Sign an affidavit before commencing work to the effect that
he has read this Article and will do the work personally and
observe all of the requirements of the Building, Electrical,
Plumbing and Zoning Codes of Miami Shores Village. Such
affidavit to be properly notarized upon blanks to be supplied
by the Building Inspector.
11. In order to prevent abuses and subterfuge the right of such
owner builder as herein provided,'is limited to but one
owner - builder permit each 2 years, and where an owner-builder
has once exercized the privilege herein conferred no second
appaication for owner- builder permit shall be granted_in less
than, 2 years, unless the applicant is qualified as a licensed
General Contractor under the applicable Ordinances of said
Village.
SUBSCRIBED AND -SWORr TO BEFORE ME this day of A+ D•.
19
NOTARY PUBLIC
BUILDING
ELECTRICAL ❑ DATF i €, 1 t.
PLUMBING ❑ P N% 9971 Contractor s
License No
ROOFING ❑
❑ Work to Eatery
:u0ll
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
MIAMI SHORES VILLAGE. FLORIDA
Lot
-A-40.V%
CONTRACTOR OR BUILDER
Bl.
Subdi-
vision
3q. Ft
Value of
Project $
Amt. of
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 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. r'
Signed—` 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
�1 OWNER'S NAME
Dr 4n, MIILS_ M & La . n L bZ'i_
NEW CONSTRUCTION
PRESENT ADDRESS
1 Z S 41 • 1.. 1 o ■ s` �S s •
LICENSE NO.
PHONE NO.
JOB LOCATION (ST. OR AVE.)
LZ ro a . 6. \01 A ST.
REPAIRS
ESCRIPTION
< D
SC.. , ■ _ L _
1 . .
LOT
2
BLOCK
1
DESC - I PTI ON
T p\
N \
Aaer... S W •1 S lJ � IA 60 1 L7 O
r . ` \1\ k 'c ' E A• AA - C
1 Gbr
SUBDIVISION
o. .lt'7
GENERAL CONTRACTOR
OW h e r do. I q. b• r
APPR6VED
REJECT D
ADDRESS
•—
REASONS
PHONE NO.
--
LICENSE NO.
1
Q
BUILDING P RMIT NO. ` -I %
DATE
2- 1 `
/
-- `. 0
PER IT FE$
ES
O
BUILDER'S BOND
NO. DATE
4 rar-d tto.l
ZONE REQUIREMENTS
CU. FT.
'i�•it 4 --t0e i 01.74.
PLAN CUBE 2.,'Z. 4.7
- - CU. FT.
"=
EST. COST $ 2 Ill Ca 0
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: 0+• Wid'rV-•-d
DAT=
3 -1G - (.
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
NEW CONSTRUCTION
TYPE
C.... Oa
STORIES
. n a:
ROOF CONSTRUCTION INTERIOR CONSTRUCTION
I extb'Ctr1 Iee a r-r ex
K lS
REPAIRS
ESCRIPTION
< D
SC.. , ■ _ L _
1 . .
ALTERATION
DESC - I PTI ON
T p\
N \
Aaer... S W •1 S lJ � IA 60 1 L7 O
r . ` \1\ k 'c ' E A• AA - C
ADDITION
SUBMITTED TO PLANNING BOARD
APPR6VED
REJECT D
REFERRED TO(?OUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SURMITTFO TO VILLAGE COUNCIL
REMARKS
`g
CERTIFICATE OF OCCUPANCY NO. / /(O 7
I i Z <G °� 7.-,
ISSUED
BY
//
I TO DP. 441 MPS. frtnit h., L( °7Z .
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: 0+• Wid'rV-•-d
DAT=
3 -1G - (.
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
INSPECTIONS
DATE
BY
INSPECTIONS
DATE
BY
FOUNDATION
S
ROOF
I
S
BEAMS & LINTELS
I
S
POOL
I
S
FRAMING
RANGE CONN.
S
AIR COND.
S
MOTORS
FINAL
S
CLEAN UP
SEPTIC TANK
SLAB
S
SOLAR HEATER
SLAB
FIXTURES & FINAL
SPECIALS PERMITS
PERMIT NO. DATE
FEE
TEMPORARY SERVICE
BY
S
SEPTIC TANK
S
SEWER
I
S
SOLAR HEATER
I
S
GAS
I
S
S
RANGE CONN.
S
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
TUB & TOP OUT
H. W. HEATER CONN.
S
RANGE CONN.
H. W. HEATER CONN
SEWER
S
MOTORS
S
FIXTURES
SEPTIC TANK
S
S
SOLAR HEATER
FIXTURES & FINAL
FIXTURES
GAS
CONTRACTOR �Q\ C Q r E C e C[ v ∎c_
PHONE
PERMIT NO. 2 1 DATE 3. Z L 1 L b
FEE S
NEW BLDG. 1 ALTERATION 1 ADD
TION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
S
H. W. HEATER CONN.
S
RANGE CONN.
H. W. HEATER CONN
S
MOTORS
S
FIXTURES
S
S
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE. INSPECT
BY
TEMP. SERVICE
ROUGH ING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
CONTRACTOR
PERMIT NO.
NEW BLDG.
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
DATE
1 ALTERATION I ADDITION
PHONE
FEE f
REPAIRS
APPROVAL TO POWER CO. FOR SERVICE DATE
BY
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
N° 1163
Owner, Agent or Tenant of Building
Plan Cube 2247
Tax Value 1124
Miami Shores Village, Florida, 12 -16-60
Dr, & Mrs. Melvin Klotz
Lot 2 Block 1 Subdivision Goidon shores
Street Address 1250 N.* 101st Street
Approved use by occupancy CONVERT scir'F,N PORCH TNT() FT,nRTfl4 Rnnm
Remarks. 9971
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 cmd 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling of buildings or structures.
Owner
0.1
BUILDING DIVISION
Permit No
Disapproved
(Signed)
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 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.
,A4(.
Owner's Name and Address De. M 6L il/ /) / / /0 2 — No / a J -.° Street � C • (d/ J7
Registered Architect and /or Engineer....... Tic/. is .�/ L1_ __ ..... N /Nee /` 1 1 y t .(.)..1 -`!/ •
_.. ./1)
Name and address of licensed contractor t __4S,/ 4[ /.l /
... .l� .4126_(-{ ( C ?_.�Oy'
Building Inspe or
Location and legal description of lot to be built on:
Lot Z Block
Date
,Aec ei / 2-
Subdivision __._._. - c In G(Ovj if .4 O !" C-5
Street and Number where work is to be done /.25-d fit/• G / di JT • /� _/�._ --��-
State work to be done and purpose of building (by floors) ___J2Q /. e__5 _/'_11 — (r 0 11_e./' / e.X.LS7 J,
Date ® — Read, Sworn to and Subscribed before me.
Dat( f
/a �� O [[ f e / f t ' /)/ /._4 11� , /A 7 � _LL G �) 4 8......5;Q 4- c�i1a/' �°oC)[�
/y0,, � f.!l�/` �°15.� /_)GCS! LC /d . /?N.‘ and for no other purpose.
New Building Remodeling x Addition / Repairs No. of Stories
/�oo
To be constructed of___ Kind of foundation e5(1. .elf r <21JC' 4l ?A/J Roof Covering r,K/1- -_.._gh /. c. /rt�
Estimated Total cost of improvements $ et. Amount of Permit $ --- G ril' �J� Z 4.
Zone cubage required.._... Vf0C) O._.- Af/.!�___- jCl_SI!_,eiJ? .Plan Cubage
Distance to next nearest building__ 20 - 0" e) s f Size of Building Lot .. JO62 - O ./fbolv /(D-O " ,Dee/
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 cinder 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 thjs
permit, as are licensed by Miami Shores Village.
Remarks ( Signed) ___ >./.7 -71 k 1
,19
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.
Notary Public, State of Florida
My Commission Expires
PLANNING 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.
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