185 NE 100 St (12)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 }wren 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...— -AMC.
Owner's Name and Address Mary K. Boulton
No 187 street... E. 100th St,
Registered Architect and/or
Name and address of licensed contrpctor ja.IGG., 54th...8.tat
Location and legal description of lot to be built on:
Lot 2 3 Block 15 ......
187 N. E. 100 Street
Street and Number where work is to be done
State work to be done and purpose of building (by floors) Patio. Roof
and for no other purpose.
New Building Remodeling Addition X Repairs No. of Stories 1
To be constructed of Aluminum Kind of foundation Roof Covering
Estimated Total cost of improvements $ 2.879)11 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 arc required by the Act. The undersigned agrees to employ only such s •ntractors, on work to be rformed un er this
pcnnit, 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.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Nlember 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 1min
the Planning Board.
A re-impection 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.
Opening No. Site Style Proj. Construction
1. 30' x 16' Patio Roof Aluminum & Steel
15'
OW?'Th : Mary K. Boulton
187 N. E. 100th Street
Miami Shores, .51a.
Existing House AAA
New Patio Roof
Back
CONTRACTOR: JALCO, INC.
7L1 N. W. 54 Street
Miami, Fla. 33127
It
STATE OF FLORIDA deportment of Professional r .Anit (Occupational letµtlfltiott ;3+
CONSTRUCTION INDUSTRY LICENSING F3UARt) �o
DATE: FILE NO. BATCH NO.
07/01/77 CH C001846 434
THE CERTIFIE.0 RESIDENTIAL CONTRACTOR
NAMED BELOW IS CF:RT.IF1ED ,
UNDER THE PROVISIONS OF CHAPTER 468 FOR .a
THE YEAR EXPIRING JUNE O. 1979
I
[
1.
.fi
qt
DISPLAY IN A CONSPICUOUS PLACE RE ' R Or RRUFEaSI:'. 7i,
GROSS. ELME R W
JALCC INC
741 N4 54 ST
MIAMI FL 33121
Opening No. Size Style Proj. Construction
1. 30' x 16' Patio Roof 15'6" Aluminum &Steel
OWNER: Mary K. Boulton
187 N. E. 100th Street
Miami Shores, Fla.
Back
CONTRACTOR: JALCO, INC.
741 N. W. 54 Street
Miami, Fla. 33127
GROSS, ELME R W
JALCC INC
741 NW 54 ST
MIAMI FL 33127
:' • '_+e ' -•1.I — CIF• _.'..��r:'�'�: ' '1 �.
STATE OF FLORIDA deportment of Professional r Antt (Glcrupattio►unI XnefµTlation �
CONSTRUCTION INDUSTRY LICENSING BOARD
DATE: FILE Na BATCH NO.
07 /01/77 CR C001846 434
THE CERTIF IE0 i ?ESIDENTIAL CONTRACTOR
NAMED BELOW I S C E R T I F I E D
UNDER THE PROVISIONS OF CHAPTER 468
THE YEAR EXPIRING JUNE 30, 1979
coveeNOa T DISPLAY IN A CONSPICUOUS PLACE ac 9• _ +GFEvSIi.A ate