1431 NE 101 StBUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL ❑ Date 19!
PLUMBING ❑ PERMIT N 10747 Contractor's
ROOFING ❑ License No
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
} R y
/ ,I
Z.,'±" js t. . f
I ci ? 3 G. 1«i ...:. r
Subdi-
vision
Sq. Ft.
Value of 11 Amount of
Project $ 11 Permit $
•
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 applica-
tion 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 respon-
sibility for work done by his agents, servants or employees.
Signed — ,. I (INSPECTOR) BY
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.
CONTRACTOR or BUILDER BY AUTHORITY
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_ ,"14/4 No Street
Registered Architect and /or Engineer
Name and address of licensed contractor_ _ " � "' �,��_me ® /aic? ' Th 4
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done ___ / __',�
State work to be done and purpose of building (by floors )___ .) rz
/ ' --
Building In ctor
Date 4
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 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 are required by the Act. The undersigned agrees to employ only such sub actors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
2
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 foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No / 0741 Date (" s— Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Notary Public, State of Florida
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.
l VVllade of Miami Shores N° 3899
JOB
ADDRESS C•� vre-NS (Z. E.% e' _
• � 7 w6, / — 's/�
L/ �'�(
INSPECTION , T 3� - ALE:. • �0 l s�
TIME READY /2 r i c
REMARKS
INSPECTOR DATE 3 --/z - ��
State work to be performe8 and purpose of building (By Floors)
Size Septic Tank dl Feet of of Drain Tile______s
Nature of Water Supply: City —Well
Amount of Permit $ _--- -. - - --
MIAMI SHORES VIU,LA.GE
PLUMBING INSPECTION DEPARTME ' :'
APPLICATION FOR PLUMBING
Permit No 3 / Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Budding 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 no.. A copy of approved plans and specifications must be kept at
building during progress of wor
New Building _._ Remodeling Addition_
Owner's Name and Address_
Registered Architect and /or En
Employing Plumber's Name Street - -• ---_ _
Location and Legal Description Lot Block_ Subdivision.
Street and Number where work is to be performed— No.___'[- - ? '�``__ Street.
Street.
Repairs No. of Stories
Type of Tank___ Gtr
Capacity Gals
eet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed)
Plumbing Inspector.
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 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied 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 sub - contractors, on k r be p • rm nder this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made'neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBE
SHOWERS
LAVA•
TORIES
S INKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAtN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE'
TRAP
SOLAR
NEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'O
POOL
CONTR.
LIST
CHECK
State work to be performe8 and purpose of building (By Floors)
Size Septic Tank dl Feet of of Drain Tile______s
Nature of Water Supply: City —Well
Amount of Permit $ _--- -. - - --
MIAMI SHORES VIU,LA.GE
PLUMBING INSPECTION DEPARTME ' :'
APPLICATION FOR PLUMBING
Permit No 3 / Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Budding 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 no.. A copy of approved plans and specifications must be kept at
building during progress of wor
New Building _._ Remodeling Addition_
Owner's Name and Address_
Registered Architect and /or En
Employing Plumber's Name Street - -• ---_ _
Location and Legal Description Lot Block_ Subdivision.
Street and Number where work is to be performed— No.___'[- - ? '�``__ Street.
Street.
Repairs No. of Stories
Type of Tank___ Gtr
Capacity Gals
eet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed)
Plumbing Inspector.
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 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied 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 sub - contractors, on k r be p • rm nder this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made'neoessary by improper notice for inspection, or faulty
materials and /or workmanship.