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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. C ovs V •10* 1/1 To FL d Cate c eJ = It 4 L tj 1x1 7 0 + 'LP. t K or c- rbm w - 4. 1`�,t to I or = d. 451, Vt. 4. 4- - fr t`- 7-.