1400 NE 101 St (7)N° 1852
Miami Shores Village, Fla, P\7: t9
Owner, Agent or Tenant of Building -4 ,
Lot Block / Subdivision
Street Address h 40,7) 'cJ
Approved use by occupancy
Remarks.
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
A
-(= 644;
This Certificate of Occupancy is issued to the above named v
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling of buildings or structures.
BUILDING DIVISION �'
OWNER'S NAME
Guernsey Const. Co.
PRESENT ADDRESS
LICENSE NO.
PHONE NO.
JOB LOCATION (ST. OR AVE.)
1400 N.E. 101st Street
LOT
3
BLOCK
1
SUBDIVISION
n
MS Bay Park Est.
GENERAL CONTRACTOR
R.V. Guernsey
ADDRESS
PHONE NO.
LICENSE NO.
15259
BUILDING PERMIT NO.
9 -30 -53
DATE
7.00
PERMIT FEE $
BUILDER'S BOND
NO. DATE
ZONE REQUIREMENTS CU. FT.
$2,500 Tax Va1u
PLAN CUBE CU. FT. EST. COST $
DRAW
NGS, SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY:
DATE
NEW CONSTRUCTION
TYPE
STORIES
ROOF CONSTRUCTION
INTERIOR CONSTRUCTION
REPAIRS
DESCR IPTION
Swimming Pool
ALTERATION
DESCRIPTION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE•SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
�� I��
CERTIFICATE OF OCCUPANCY NO. /
l J�
ISSUED I v - -6G
B\
TOt�* %; -- - .,....■
BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE
INSPECTIONS
DATE
PERMIT NO. DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
I- ..
` �
$
SEPTIC TANK
BEAMS & LINTELS
$
SEWER
$
SOLAR HEATER
FRAMING
$
GAS
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
FINAL
1 C-'
CLEAN -UP
SEWER
CONTRACTOR
PHONE
PERMIT NO. DATE
FEE $
NEW BLDG. I ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
SEPTIC TANK
$
SEWER
$
SOLAR HEATER
$
GAS
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
GAS
SEWER
SEPTIC TANK
SOLAR HEATER
FIXTURES
CONTRACTOR
PHONE
PERMIT NO. DATE
FEE $
NEW BLDG. 1 ALTERATION 1 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
- ..1PPROVr^L TO POWER CO. FOR SERVICE DATE
BY
BUILDING { ,1 ^'' DATE • - Yrk_ -- AI 195 2
ELECTRICAL ❑ PERMIT N? 15259 p, cto w
PLUMBING CI ' .; % _; N �� '�'
ROOFING ❑ Work to be performed under this Permit
Owner of
Building _ s,,. ?►..
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
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.
CONTRACTOR OR BUILDER
Signed
Subdi-
vision
Value of 2
Project $ � S
Amt. of
Permit $ - women
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.
BY AUTHORITY
Owner' Name and Address___
Registered Architect and /or Engineer
Name nd address of licensed contractor. ___
Location and legal description of lot to be built on:
Lot_ __. Block_._
Street and Number where work is to be done_
New Building, _ Rernodeling__
To be constructed of_ _ _ Kind of foundation
Estimated ,ta1 cost of improvements $ ®Q
Zone ^ubage required. __.
Distance to next nearest building__ _ _
Maximum live load to be borne by each floor_ _ . _____
STATE OF FLORIDA,
COUNTY OF DADE.
and who, being by me first d. 1
of di abov de. ed • istru.
therein by him s . ;131c,
-
/ D.
n
Permit No
Disapprov
(Signed) ____ _ t
Chairman _
Member ____
Member
Council Approved
ss.
MIAMI SFItRES VILLAGE
BUILDIN INSPECTION DEPARTMEN'
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the det. iled statenien• of the plans and specifications herewith submitted for the build-
ing or o h. -ructure her 1 described. This i-i licatic is made in compliance and con •o'm ty w.th the Building Ordinance of Mia ii
Shores Village, .or da, and all pro. isions of the Laws of the State of 1. h. rid. all o d nances ,,f Mi .mi Shores Village and all rules and
regu•a'ion, of the Budding Div.. i of .tam Sho. illage h 1 1 e -o• ipl.ed with, whether herein specified 9r not. A copy of approved
plans and specificati ms must be kei at building durin progress of the wcrk.
Date_
ector
Subdivision
IVoa
State work to be done and purpose of building (by floors) j
and for no other purpose.
No. of Stories.
® 6 Cov ring__
Amount c`. Permit $.
plan Cubage ia - ___ ti •92.V
_Size of Building Lot
Addition____ ___ -__ _____ __ _ Repairs. _
hereby submit all the plans and specuieations for said building. All notices with reference to the building and its
be sent to
The unde signed appli ant for th's building permit does hereby certify clat he understands and accepts his .•bligations as an employer
of 1 bor under he Florida Workmen's Compensation Act be ng S- , tion 5966 Coi p led Gen
N•e. /6/ -c
(Sigie
Member
Member
Member
_Date Disapproved
/
Date ���;
- - - - -/e z_21.._ _4/__ '. /3 - -• --
and h s compl ed wtth he prov'aons thereof, and will require s•milar comp lance from all c
in the wo k to be p rt med under th s pern it and ill post or cause to be posted for insp
or .otit es as are requir d by the Act. The u. d,r ign sd agrees to employ only such/ abc
permit as are licensed by M am: Shores `il•: ge.
Remarks__
al Laws of Florida P r anen. S•ipplt uent.
tractors or sub - contractors inplo .ed by him
tion on the site of the or - s i :h public not] e
ctors, on work to , -rforn. d . der this
No----- --- -- ----- -• -- --- -. Street
Read, Sworn to and Subscribed before me.
Notary Public State of Florida
LANNING BOARD DATE
,19
construction may
Before me, the undersigned authority, a notary public, duly authorized to adm :nister oaths and take acknowledgments, personally p p-
pearcd
.to me well known,
sworn, upon oath depo , .es and says that he is the
n t, • h has careially read the foregoing application, and that he did sign the same, and that all facts
My Com :nission Expires.
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application Ifter approval his been obtained from
the Planr ng Board
A re- inspection fee of $1.00 will be charged when such re- inspection is mu ie necessary by improper notice for inspe :•t•or or fa• Ity
materials and /or workmanship.