1239 NE 100 St (5)Name and address of licensed contractor
Location and legit description of lot to be b
CHANGES.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby usnde for the npproval of the detailed statell,enr us inc plans and specifications herewith submitted for the build •
Jog or other structure herein described. This application Is made In compliance and conformity with the Building Ordinance of Miarnl
Shores I Inrid.s. 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..._...._..._..IANIIARY .�..14.,...l�H..._.... ,19..—.-
Owner's Name and Address JOSEPH . PEQUENO. 1239 N . 100 STREET N ,J � uw2A ,
Registered Architect and /or Engineer
Building Inspector
SECURITY WINDOWS .
S t]R t 7i= -
ilt on:
Chairman
Member
Member .. .. �.
Council Approved Date
fl fIt
5100 N.W. 72 AVENUE. MIAMI,, FLORIDA 33166
Subdivlsloo le /........ O
Lot. ... nlock
1239 N.E. 100 ST1REET. MIAMI SHORES
Street and Number where work is to be done
State work to be done and purpose of building (by floors)..
REPLACING 2 JAL WDWS
and for no other purpose.
New Bui!ding Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Cove
Estimated Total cost of improvements $ 482.00 Amount of Permit $
d ,s
Zone cubage required .._...Plan Cubage
Distance•to next nearest building Size of Building Lot
Maximum live Toad to be borne by each floor
1 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 o. ►gations as an Employer
of Libor under the Florida Workmen's Compensation Act, being Section 5960, Compiled General Laws of F ri ' Permanent Supplement,
and 11.11 complied ss ith the provisions thereof, and will require similar compliance from II contractors or s tractors employed by him
in the work to be performed under this permit; and will post or cause to be posted fo spection on the s f he work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such s 1 •ntradors, on _ •rmed under this
permit, as are licensed by Miami Shores Village.
Remarks
(Signe
/3 e `99�7
STATE OF FLORIDA,
COUNTY OF DADE. f ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
SEYMOUR GOTHELF.
peared .___.. _.. _.. ..._... -
Notary Public, State of Florida
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
tiic I'1.uinir.:4 Board.
A re•i►i'pe•ttion fee of $1.00 will be charged when such re- Inspection is made necessary by Improper notice
materials and/or workmanship.
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of tl:e above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fads
therein by him stated are true.. / �./
Permit No. 9 Date / /.[. / /g�1 Read, Sworn to and Subscribed before me.
ved Date. \ �Q _ .
Disappro
(Signed)
My Commission Eapires_1%' 1lQI&BY.2118144440F trFZURIDA
NY COMMISSION EXP JULY 25,1991
PLANNING BOARD DATE BONDED IHRU GENERAL INS. UND.
Member
Member ..._...._ .................
Member _.._.....
Disapproved Date
has been obtained (mot
for Inspection or faulty