358 NE 100 St (14)APPLICATION FOR BUILDING PERMIT
Owner's Name and Address
Registered Architect and/or E gineer
Name and address of licensed contractor
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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 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 regula-
tions 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.
Location and legal description of lot to be built on:
_____ Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
--------
---------
New Building Remodeling
To be constructed Kind of foundation
Estimated Total cost of improvements $
Zone cubage required_
Distance to next nearest building
Maximum live load to be borne by each floor
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
Building Inspector
______Size of Building Lot
Before me, the undersigned authority, a notary public, duly authorized
appeared
Disapproved _______________ Date
(Signed)
PLANNING BOARD
Addition_
Chairman
Member
Member
Council Approved
YO __,.4.<[?! .. - 1 ,2 At
'
_Amount of Permit
–.—Plan Cubage
Date_ 19_14/
Repairs
Roof Covering
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 be 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. ---N
,',)
Remarks (Signed)
,,,--
to administer oaths and take acknowledgments, personally
and who, being by me first duly sworn, upon oath deposes and says that be is the
of the above described construction, that he bas carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No Date_
- 00 4/1 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires.
DATE
is made necessary by improper
4./
__and for no other purpose.
No. of Stories
to me well known,
Member
Member
Member
Date Disapproved
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
materials and/or workmanship.
notice for inspection or faulty
New Building_
To be constructed of
Owner's Name and Address
STATE OF FLORIDA,
COUNTY OF DADE.
. 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 building
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 regula-
tions 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.
Disapproved Date
(Signed)
Registered Architect and /or Engineer , _,.ecoA
Name and address of licensed contractor
Location and legal description of lot to be built on:
4e ��_ Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
Remodeling Addition__
Kind of foundation
Building Inspector
Date_—.
Estimated Total cost of improvements $_ __ ___ —_ _ —_ _ _ __ —_— Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest of Building Lot
Maximum live load to be borne by each floor
rm. _.._�
•
and for no other purpose.
Repairs No. of Stories
Roof Covering
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 subcontractors, „.9n work to be perfor ed under this
permit, as are licensed by Miami Shores Village. / �
Remarks (Signed)177#11,1+
a, / • ` d
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, tbat 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 a ^T / Date a te' / / Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Ccmmission Expi:ea _____
____�____�_
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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
v
MIAMI SHORES VILLAGE, FLORIDA /id
DATE
PERMIT N? 1689
Contractor's
License No
Work to be performed under this Permit
Bl.
7
Subdi-
vision
Value of
Project
Amt. of
Permit
19412_
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 rewoosibility 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.
Signed. 1 :. , .. ' By
INSPECTOR II
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions pertaining thereto and in strict conformity with the plans, drawings, statement* `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