1280 NE 101 St (9)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date dO 7 Job Address 1 f•JE l o I S'r' * Tax Folio I - 3 Z.o5 - O Z-) 00 t O
Legal Description L-6 B 1 k- 45 P F.512. PG -4 °Historically Designated: Yes No
Owner/Lessee / Tenant CA-AO t) (A Pv c7
Owner's Address \ 22b0 1)L. l 0 t 54- i Phone S Cr.
Contracting Co. Q Lome i Address S
•
Qualifier /t) Al SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer 6 E L F Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING ' AVING FENCE SIGN
WORK DESCRIPTION A DE> c-(1 r\ P2, S Vim- a9`"? k PiM,g -LT f OO/w ,ce f e_
Square Ft. , 0 Bu a
I
Estimated Cost (value)
Master Permit #
3 ry b0 00
g 5'/
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT LI0 (2 a RADON
C.C.F.
Not _...__
My ' onkrtai i fAtAL NOTARY L
�
O _ , SANDRA LI I OWTIEL
it 1 S ' A. COMMISSION NUMBER
,, d CC401261
-71 O RAY COMMISSION .EXP.
,�rner
NOTARY
Electrical
ignature of Contractor or Owner Date
ce„v07...eJD?).29
Date
TOTAL DUE 6/7 ov
APPROVED:
Zoning Building
Mechanical Plumbing Engineering
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LEGEND : FIP= Found Iron Pip;' F N/D =Found Na i 1 E. Disc
S.P.C. = SET 1/2" PIN E. CAP LB47139 FIR =Found Iron Reber
S.PCP= SET PERMANENT CONTROL POINT L84789
q= CENTERLINE. P /L= PROPERTY LINE. 0 /L= ON LINE
M.H.= MANHOLE. WM= WATER METER, PP= POWER POLE
F.C.= FENCE CORNER. R= RECORD. M= MEASURED .
CHAIN LINK OR WIRE FENCE
W000 FENCE -
MASONRY WALL -
CONCRETE= ti :• . •: .j
NOTES: BEARINGS SHOWN ARE REEFERED TO A:(�ASSUMED VALUE SAID PD.
NOTES: UNLESS OTHERWISE SHOWN, THE FOLLOWING NOTES APPLY.
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U comparison a cparison is shown, all bearings and distances shown are the sarrre as plate values. 3) The
shown hereon were not abstracted for Easements or other recorded emcumbrances not shown on the •Ia; alc
any may not be shown on this sketch. 4) Underground portions of Footings. Foundations or other improvel•1c
located. 5) Elevations are based on National Geodetic Datum. 6) Fence Ties are to the Centerline of the fe
Ties to the face of the Wall.
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MIAMI SHORES VILLAGE
BUILDING INSPECTION C3EPARTMENT
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.
Owner's Name and Address Mr- r
Registered Architect and /or Engineer
Date..._....1.. ` 1 _ .. ...... 19 2Y
,
� _ No,t `L�� ...._... street. l� ... .
Name and address of licensed contractor A-
Location and legal description of lot to be built on:
Lot 1 Block..... /. t/ 14 Subdivision
c o
Street and Number where work is to be done / A .�1' /� ... L o > s r
.._.._�
State work to bp done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling Addition {�— Repairs No. of Stories
To be constructed of 1 ... - of . P,__. k Covering
Amount of Permit L • ` ''
_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 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, Pennanent 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
pennit, as are licensed by Miami Shores Village. y /
Remarks..._ (Signed le r.,lja
Estimated Total cost of improvements $ / OO,�
Zone cubage required
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
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 a.. tion, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No. ._.... . c> Date
Disapproved
(Signed)
ate
Building Inspector
PLANNIN
worn to
/f- ( r- 7
Chairman
Member
Member .......
Rea
BOARD DATE
nd Subscribed before me.
tary Public, tats of Florida
ommission Expires
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 (min
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 of faulty
materials and /or workmanship.
I OWNER'S NAME
DR. PAUL DUNN
'PRESENT ADDRESS
1280 N.E. 101sd Street
LICENSE NO.
1878
PHONE NO.
JOB LOCATION (ST. OR AVE.)
1280 N.E. 10Mst Street
LOT
1
BLOCK
184A
SUBDIVISION
Miami Shores Sec 8
GENERAL CONTRACTOR
Owner Day Labor
ADDRESS
PHONE NO.
LICENSE NO.
BUILDING PERMIT NO. 5 37 6
DATE 4 -18-57
PERMIT FEES 9;00
BUILDER•S BOND
NO. 211 DATE 2 -57
Addition REQUIREMENTS CU. FT.
ZONE
PLAN CUBE 18,155 CU. FT.
EST. COST S 5,000
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: C. H• Markel
DATE
4 -21 -57
NEW CONSTRUCTION
TYPE
STORIES
ROOF CONSTRUCTION
INTERIOR CONSTRUCTION
REPAIRS
DESCRIPTION
Screen Patio ?Addition
ALTERATION
DESCRIPTION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
CERTIFICATE OF OCCUPANCY NO. '°
ISSUED
BY
P a
TO
BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION -s 77
-Y) ,,,/jA P 0.47,za
FEE
- +b }le./
S .
Ole I,a.t —
(.—ZY
BEAMS & LINTELS 4C,
.4 ° `7 /WY
I - 7•f
S
SEWER
$
RANGE CONN.
FRAMING
SOLAR HEATER
$
MOTORS
$
GAS
$
FIXTURES
$
$
$
INSPECTIONS
FINAL
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
CLEAN-UP
TEMP. SERVICE
GAS
CONTRACTOR
PHONE
PERMIT NO. I. DATE
FEE $
NEW BLDG. 1 ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
FEE
TEMPORARY SERVICE
$
SEPTIC TANK
$
H. W. HEATER CONN.
S
SEWER
$
RANGE CONN.
$
SOLAR HEATER
$
MOTORS
$
GAS
$
FIXTURES
$
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
BY
TEMP. SERVICE
GAS
ROUGHING
SEWER
H. W. HEATER CONN
SEPTIC TANK
RANGE CONN.
SOLAR HEATER
FIXTURES
FIXTURES & FINAL
CONTRACTOR
PHONE
PERMIT NO. DATE
FEE $
NEW BLDG.
ALTERATION I
ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE
BY
r),
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.
Owner's Name and Address Ja.1.4"
Registered Architect and /or Engineer..._
Disapproved Date
( Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date
Name and address of licensed contractor
Location and legal description of lot to be built on
Lot 1 Block t' Q. D Subdivision._G
Street and Number where work is to be done / z _. 0 }�2 - 7
State work to be done a pure se_o_f b floors)
I hereby submit all the plans and specific ions for said building. All notices with reference
be sent to
fze,-
New Building Remodeling Addition._. Repairs
To be constructed ofi 4.it _. p Kind of foundation
Estimated Total cost of improvements $ ..,� -
of Cover
Amount of Permit $
Zone cubage required plan Cubage
Distance to - next nearest building __..._...___2__ ' - - Size Building Lot /0 2 .L2-,k' tz f 6
Maximum live load to be borne by each floor
to the building and its construction may
The undersigned applicant for this building, ennit 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 p rformed under this
permit, as are licensed by Miami Shores Village.
v llage. p 1
Remarks Z 4 - Z Z Z (Signed)_ 7_e
- � �� e-e 24 ___ --fir _GGe-a
STATE OF FLORIDA, ( ,—.,
COUNTY OF DADE. i 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.
Permit No Date Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
,19 S 7,
Street
and for no other purpose.
No. of Stories �f
ing_ --- /� C/L� L.1 � 4 ,
Building 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 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.
,rpo
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—
/ TO
STATE OF FLORIDA) SS
COUNTY OF DADE )
A F F I D A V I T
Dio /Zit_ /)v pJ N of 'the Village of Miami Shores, County
of Dade and State of Florida, being duly sworn, doth depose and say, that under
the provisions of Ordinance No. 185, dated June 15, 1948, amending paragraph
(d) of Section B =368 of Ordinance No. 97 of the Building Code of Miami Shores
Village, he desires to build a oo j /2,,,o, e 4( L,,,, ,�< Z •J �7/ J
on Lot / Block , �¢ pr} of q „ ,,, � Sr S. diyi or
that he is the owner of said property, and will be the owner of said
, that he will do the work personally, 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.
2. Apply for and secure a Permit.
3. Pay the required fees.
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 certificates
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
application 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.
And Further this Deponent says not:
SUBSCRIBED AND SWORN TO BEFORE ME this day of
195
NOTARY PUBLIC
A.D.,