1490 NE 101 St (12)OWNER'S NAME
J o/L0�t.1 St IA err• - 4) .
PRESENT ADDRESS
i-4-�c KI - `• It>t — S
`
LICENSE NO.
PHONE NO,
JOB LOCATION (ST. OR AVE.)
0 4. .,z.. 6,1 L ` bGO'i.�. t)
LOT
1 3 A N Y.,- 1
BLOCK
1
SUBDIVISION
1-r k / 6,- F
GENERAL CONTRACTOR
eJ . .�;.tL
ADDRESS
PHONE NO.
BUILDER'S
NO.
LICENSE NO.
BOND
DATE
BUILDING PERMIT NO. 4C -z_4-
DATE L"-I l - ( 4
/mob r--"
PERMIT FEE $ /1224:' 1■—
PLJOITICSIV
ZONE REQUIREMENTS CU. FT.
PLAN CU� BE / Zt7 /• CU. FT.
EST. COST $'i I� ��
DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: W r-e)42-� -D 1
DATE.
"' -11 - Q1
NEW CONSTRUCTION
TYPE
G PD
STORIES
oa e
ROOF CONSTRUCTION
. (4 cy
INTERIOR CONSTRUCTION
Fco2 , a A J ?flirt AMA 7100✓
DESCRIPTION
r . LC yY// / '/
REPAIRS Le.-,-, to n " r %' Th ' 4,,, 4 'TG r e c C.-XS-US J a 4" 4i 7 —
ALTERATION
`r / DESCRIPTION j
- owl Le. r r:r....
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTFD TO VILLAGE COUNCIL
REMARKS
CERTIFICATE OF OCCUPANCY NO.
ISSUED
BY
TO
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
INSPECTIONS
DATE
BY
INSPECTIONS
DATE
BY
FOUNDATION
$
ROOF
I
$
BEAMS & LINTELS
$
$ •
POOL
I
$
FRAMING
S
AIR COND.
DATE
BY
FINAL
BY
RE- INSPECT
CLEAN UP
ROUGHING
S
SLAB
FIXTURES & FINAL
S
TUB & TOP OUT
SLAB
SPECIALS PERMITS
PERMIT NO. DATE
FEE
TEMPORARY SERVICE
I
$
SEPTIC TANK
$
SEWER
I
$
SOLAR HEATER
$
$ •
GAS
I
$
RANGE CONN.
S
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
S
FIXTURES & FINAL
S
TUB & TOP OUT
SEWER
SEPTIC TANK
SOLAR HEATER
FIXTURES
GAS
CONTRACTOR
PHONE
PERMIT NO. 1 DATE
FEE $
NEW BLDG. 1 ALTERATION 1 ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
H. W. HEATER CONN
$
RANGE CONN.
RANGE CONN.
$
MOTORS
$
FIXTURES
S
FIXTURES & FINAL
S
INSPECTIONS
DATE
BY
RE- INSPECT BY
RE - INSPECT BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
CONTRACTOR
PERMIT NO.
NEW BLDG.
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
DATE
1 ALTERATION 1 ADDITION
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE
PHONE
FEE S
REPAIRS
BY
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Location and legal description of lot to be built on:
Lot 13 ts, J D. Block
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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.
DatedLc 7
Owner's Name and Address No StreeiJ
Registered Architect and/or Engineer _R ICC LO
Name and address of licensed contractor orj-W-AVeR v V.) Ern- -
Street and Number where work is to be done /'L1 / 0 .efire
State work to be done and purpose of building (by floors) ,F1.1/4
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of C jj' S Kind of foundation ./.2.a.V.0.1,../..711.!C Roof Covering G.. 4 —
Estimated Total cost of improvements $ 3..../44....0.0 Amount of Permit $ Art, c....)
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Subdivision rir Ara R "4_4 __ELP 4::
Maximum live load to be borne by each floor
I hereby submit all the plays nd 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) r
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 U
("-
Permit No 1'47
Date__ Read, Sworn to and Subscribed before me.
Disapproved _.. Date
Notary Public, State of Florida
(Signed) . 411111
Building Inspector My ission Expires
PLA NG 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.