345 NE 100 St (10)r
1
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby uinde 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 tame and Address Richard E. & Elizabeth T Lasch — N 345 Street._N.E. 100 Street
Charles H. Markel — Architect
Registered Architect and /or Engineer
peared
N /A
Date..._ ... __�%f ._. 0.215 ,19.2 --
Name and address of licensed contractor Owner ---
Location and legal description of lot to be built on:
Plat Miami Shores Section
Lot 19 & E2 A of 18 Block 39 Subdivision %
N
Street and Number where work is to be done 345 E. 100 Street
---- •• -• - --
State work to be done and purpose of building (by floors) Addition to residence and brick facing
and for no other purpose.
New Building Remodeling X Addition X Repairs No. of Stories
CBS Concrete Tar & Gravel
To be constructed of Kind of foundation . Roof Covering
Estimated Total cost of improvements $ 10,000. 00 Amount of Permit $ d �i r i
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot 71)4- pi'
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... 345 N3.
The undersigned applicant for this building pennit 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 ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be rform under this
pennit, as are licensed by Miami Shores Village.
(Signe )sass_ + _. - .. --
Remarks � � � %~-�/
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-
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._ J.7 7 Date JO )Zf -- • - - - -•- Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Bu'Iding nspector My Commission Expires
Notary Public, State of Florida
PLANNING BOARD DATE
Chairman Member
Jicrnber Member
Membersa ss.. _. - - - ._...._....... Member sass_ __._...•.
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 hoard.
A re - inspection fee of 31.00 will be charged when such re- inspection is made necessary by Improper notice for inspection at faulty
materials and /or workmanship.