1350 NE 101 St (12)BUILDING
ELECTRICAL
PLUMBING ❑
ROOFING
Owner of ''
Building +..
❑ PERMIT N° 14631
❑ Work to be performed under this Permit
Architect
Contractor
or Builder
r
Legal Lot II BI.
Description 1.
Address of
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
DATE
Contractor's
Dense Ns
r,,t
195
4. ..,...r Value of Amt. of
Building , fi, f .,. { ti , . .: 'i Project $ ;` .,} Permit $
BY AUTHORITY
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.
Signed - � t 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.
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.
Owner's Name and Address G tgjf S
Registered Architect and /or Engineer
Name and address of licensed contractor . _
Location and legal description of lot to be bui lt on:
Lot 2.- Block
Subdivision - - - -- ___
Street and Number where work is to be done 1.3__ 0 1 U • [ O l St"
work to be done and purpose of building (by floors) ___
New Building Remodeling Ad on___ Re p airs
To be constructed of L� % > Kind of foundation ' Roof Covering
�
Estimated Total cost of improvements $ 1 5 o Amount of Permit $
Zone cubage required 3. � am. _Plan Cubage
Distance to next nearest building n __ Size of Building Lot 7 0 lc 1 sv
Maximum live load to be borne
I hereby sub it all the pla
be sent to
by each floor
s and specifications for said building. All notices with reference to the building and its construction may
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 Gen•ra Laws of Florida, Permanent Sup plcment
and has complied with the provisions thereof, and will require similar compliance from all" contr. ctors or sub - contractors employe by him
in the work to be performed under this permit; and will post or cause to be posted forfnspecti.n on the site of the •rk al, public notice
or notices as are required by the Act. The undersigned agrees to employ only such, subcon ctors, on work to b p ormed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed
Permit No
Disapproved
(Signed)
Date
ing nspector
Chairman
Member
Member
Council Approved Date
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re-inspection fee of $1.00 will be charged
materials and/or workmanship.
Date M fry 4 , 19 5" 3
C� S 1 T • G_i AJC•No 102- Street .
PLANNING BOARD DATE
and for no other purpose.
No. Stories j
r
Read, Sworn to and Subscribed before me.
awc--
STATE OF FLORIDA,
COUNTY OF DADE. j 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 foregoi _ .. 'cation, and that he did sign the same, and that all facts
therein by him slat . e true.
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
Disapproved Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty