1450 NE 101 St (4)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement tn Inc plans and specifications herewith submitted for the build,
in 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
ti
regulaons 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.
umi.roh 19, 19.2
Name and Address George D. KelinfQ1d M.D. N 1450 st N.E. 101st.
Registered Architect and/or Engineer
Name and address 01 licensed contractor Calumet Windows, Inc. 7101 N.W. 74th, St., Medley, Fl .
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done- N.E.101 st. St
State work to be done apd purpose of building (by floors) Remove 18 existing windows and install 18
aluminum awning type windows. No structural changes. gianerior 1ITI-E114
HTL-8147, 75-189-4Y, Forced Entry.
and for no other purpose.
1.8 Andow,9
Stores
New Building Remodeling Addition Repairs No. of
To be constructed of Kind of foundation Roof Covering
.
Estimated 200 • 00
ated Total cost olimprovements $ Amount of Permit $. 11 70
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
Calumet Windows, Inc. 7101 N.W. 74th. St., Medley, Fl. 33166
to
The undersigned applicant for this building permit does hercby 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 ss itli 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 noticcs as arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, 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
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that lie 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. JA4..2 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
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be madc for making corrections or changes to this application after approval has been obtained Imin
the Planning Bo.ird.
A re Ice of $1.00 will be charged when such re-inspection is made necessary by Improper notice for inspection of faulty
materials and/or workmanship.
33166
•••
to me well known,