164 NE 100 St (6)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMET'
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.
\ 1 Date Q l� t sf_c --
, 19_(a
Owner's Name and Address �41__ S _t1 - L ' h\..4t 1��C No ���1.) Street___
Registered Architect and /or Engineei
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block !! Subdivision
Street and Number where work is to be done_________ 4 __ iE 4 e cc '
State work to be done and purpose of building (by floors sLea - WA.av p • a
and for no other purpose.
New Building Remodeling X Addition Repairs No. of Stories )
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 1 S_ ° Amount of Permit $ • b
Zone cubage required , \ .Plan Cubage
Distance to next nearest building Qa .1w�e.NA Size of Building Lot
Maximum live load to be borne by each 1oor
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 : . subcontracto on work to be performed under this
permit, as are licensed by Miami Shores Village. \
Remarks (Signed �,}
Tl�
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 l___ o
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
Disapprove
(Signed)
Building In
Date
D
.
/PLANNING BOARD DATE
ctor
0
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
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.
1
BUILDING
'ELECTRICAL
PLUMBING
Owner of
Building
Architect
PERMIT N? 5100
Work to be i erformed under this Permit [�
r 0
/ yl1 e
or Builder
Contractor 1 1
Legal Lot
Description
MIAMI SHORES VILLAGE, FLORIDA
DATE / 194
Subdi-
vision
Address of 6 , 1 Val �% ",
/ A 77 r , / o ' A Protect t This permit is granted to the cactor or b name d above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinates 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 mynicipal 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 ch ged without • thorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above ass -' e responsibil't rfor a iorough knowledge of the ordinances and
regulations pertaining a
ng to the work covered hereby whether shown on the planrdr ,. �o ' _ st. ent o specifications and that he assumes respon-
sibility for work doe by his agents, servants or employees. /+�'
" Signed
I IlirrETOR
Inconsideration of the issuance to me of this permit I agree to perform the work coveredjhereunder in compliance witaa ordinances a i ations
pertaining' and in strict conformity with the plans, drawings, statements or specifications submitted to the proper ant/Wales of Miami Slip s illage.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
f a y fL:, ' 4.4.y., /1 COL s-
CONTRACT,, R 011 BUILDER 0 , BY
Contractor's
License No
By.
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of I
Building � ;� ��
F
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE
Contractor's !�
wive '. e 4
License No. wive
PERMIT N? 5100
Work to be
7
rformed under this Permi
Signed:
/ 1941
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 appli-
cation 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 cha}ged without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assum ,tre res.. ibilit e bkm.. a , rough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or dr""aVi . . €nts yfr 4ecifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
By 7
CTOR
In consideration of the issuance to me of this permit I agree to perform the work covered Jaereunder in compliance with all ordinances and relations
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
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.
Date ,
Owner's Name and Address t4t_' 1-Le(,LR--g_T 44.q_T_ `No 140 4 Street_ __ ALP' ) 0 _e)f�st,____
Registered Architect and /or Engineer
Name and address of licensed contractor Q_J!YhLE_R
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 1 !n4__11[.1A_G? L,_3 r,
State work to be done and purpose of building (by floors) A_S?_r) Cr St A{___T4±__ A1�' A2_L 7:6_0 L__1:.1tsd_5.6
• 'New Building Remodeling Addition Repairs No. of Stories
To be constructed of Ca_t" S_,. Kind of foundation Ste_ CL,. Roof Covering r6 At R! L__-Ta1_ , ____
Estimated Total cost of improvements $ 2c, C =" Amount of Permit $__.f•
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 wor o I - p ` ormed under this
permit, as are licensed by Miami Shores Village. _ V/
Remarks (Signed) , /' VP/
Remarks / • I
STATE OF FLORIDA,
COUNTY OF DADE. j SS.
`MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
and for no other purpose.
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 4.
therein by him stated are true. R f Aft Permit No �/ Date__! (�) 4 Read, Sworn to and Subscribed before me. 1,1,0149/‘ ?
Di::v& rod , at
id
of Florida
State Public, t
Noay uc, ae oora
d) f 9/$4
u spector 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.