70 NE 100 St (9)CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
N° 1122
Street Address 70 N.E. 100th St.
Plan Cube 8022
Tax Value 4011
Miami Shores Village, Florida, 8 -
Owner, Agent or Tenant of Building THOMAS H. RAINES
W 35' of 3, all 125 of
•
Lot B � dc —� Subdivision M•S• #1
Approved use by occupancy 2 Bedroom and Bath Addition
Remarks. 204
This Certificate of Occupancy is issued to the above named Owner
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling of buildings or structures.
BUILDING DIVISION
OWNER'S NAME
710,, .t . d. PA/ d E s
PRESENT ADDRESS
70 A/ -E , /6 &;
LICENSE NO.
PHONE NO.
..yy '/JOB LOCATION (ST. OR AVE.)
0 C. /O 0
LOT BLOCK SUBDIVISION
r. J Id" Lr 3 4 Y Pi 4 Eas of till atf.a 9 - S / . /
1� nn GENERAL CONTRACTOR
I✓797A.) !4 a/r45 5 ,cf —
ADDRESS
PHONE NO.
LICENSE NO.
p
BUILDING PERMIT NO. 1-0 4-
DATE S
nco
PERMIT FEE $ 4� �_
BUILDER'S BOND
NO. DATE
4,1901 T(o►J
ZONE REQUIREMENTS CU. FT.
YLL`A, 1/4 ii-c..0 C a Quo((
PLAN CUBE va - 1 - 1.-- CU. FT.
eA
EST. COST $ g3 o ob
�� M
DRAWINGS, SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: '- FNUE
n IL`,
s DATE
4. ` 1 O
NEW CONSTRUCTION
TYPE
- . -
STORIES
Leap
ROOF CONSTRUCTION
�I t._.•
INTERIOR CONSTRUCTION
Z limo . ..4-A f.+
REPAIRS
DESCRIPTION
�1 / /'► A
4 1,O I p - I.rc O-{+4)C. Foo2S fry a p r,,,, /�7 O
o-- °'
ALTERATION
DESCRIPTION
&ao0 g" AU Tie, 4„ - Ti LE S. /1 -
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SURMITTF.D TO VILLAGE COUNCIL
REMARKS
CERTIFICATE OF OCCUPANCY NO. I 1 Z-
ISSUED �� ��
BY
� 1 1 �
TO 1 1 0201. �1 /lr Y- 124 , -
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
$j- 01 -C
INSPECTIONS
DATE
BY
INSPECTIONS
DATE
BY
FOUNDATION
ROUGHING
1
ROOF
SEWER
'BEAMS & LINTELS
1 S
SOLAR HEATER
POOL
$
FRAMING
AIR COND.
MOTORS
FINAL
0
5 ei
FIXTURES
CLEAN UP
SEPTIC TANK
5 •;
SLAB
S
SOLAR HEATER
SLAB
SPECIALS PERMITS
PERMIT NO. I
DATE I FEE
TEMPORARY SERVICE
1
1 S
SEPTIC TANK
ROUGHING
1
1 $
SEWER
ROUGHING
1 S
SOLAR HEATER
$
GAS
15
MOTORS
I s
INSPECTIONS
DATE
BY
RE-INSPECT
BY
RE-INSPECT
BY
ROUGHING
DATE
FEE
TEMPORARY SERVICE
ROUGHING
S
TUB & TOP OUT
5
RANGE CONN.
SEWER
MOTORS
RANGE CONN.
0
5 ei
FIXTURES
SEPTIC TANK
5 •;
S
SOLAR HEATER
FIXTURES & FINAL
FIXTURES
GAS
CONTRACTOR n.3 Ef.----- .., . n
-,.,
PHONE
PERMIT NO. -2-1 A c 1
1 DATE 6--- V C. ,e,
FEES
NEW BLDG. 1 ALTERATION > 1 ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
ROUGHING
S
H. W. HEATER CONN.
5
RANGE CONN.
$
MOTORS
RANGE CONN.
0
5 ei
FIXTURES
5 •;
S
INSPECTIONS
DATE
BY
RE-INSPECT
BY
RE- INSPECT BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
CONTRACTOR 4r.-. c i ) v C C
PERMIT NO. - 2-AZ- 1 DATE -S
NEW BLDG. 1 ALTERATION 1 ADDITION
PHONE
FEE $
REPAIRS
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE
BY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of {.
Building
Architect
Contractor
or Builder r ''
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
o PERMIT N? 332
Signed.
r
DATE 19 I �:
Contractor's
License No. ' r
Work to be performed under this Permit
B1
Subdi-
vision
Value of k
Project $ ` 3:
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.
Amount of
Permit $ `
BY.
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with Ell ordinances and regulation'
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In/
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
ABBOT PRINT
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architects
Contractor
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE 19 t�
■ ERMIT N9 ' i
e ta?crirEa
CONTRACTOR OR BUILDER
Work to be performed under this Permit
Bl.
BY
Subdi-
vision
Value of
Project $
P'
11 Amount of
II 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 ` , 1'' BY •
INSPECTOR
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 ac-
cepting this permit I assumelespopsibilitay all work done by either, myself, my agent, servant or employee.
AUTHORITY
r
ABBOT PRINT
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Address of
Building
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 212
Signed-
Work to be performed under this Permit
B1
This permit is granted to the contractor or builder named above to cons ruct 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.
13Y
Contractor's
License No.
Subdi-
vision
Value of
Project $
DATE �� � 19
11 Amount of /
II Permit $
BY:
INSPECTOR
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 ac-
cepting this permit I assume responsibility for all work done by either, , myself, my agent, servant or employee.
AUTHORITY
ABBOT PRINT
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE T‘- 19 •
PERMIT 298 Contractor's
License No. - 5
0
❑ Work to be performed under this Permit
r '
CONTRACTOR OR BUILDER
B1
Subdi-
vision
' M�
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 bee 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- BY •
INSPECTOR
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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent; servant or employee.
BY AUTHORITY
ABBOT PRINT
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.
_ Date / 3 , 19 C
Owner's Name and Address.. if, R A- f N E No 7 v NI,E Street /O O ST
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
i p
Lot 4 ,' Block / Subdivision
Street and Number where work is to be done 70 /l/,C, ! 0 0 s r-
State work to be done and purpose of building (by floors)
-1 15706 D /x.e
lANll Stt0'?�S
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering ,8v /'L r U P
Estimated Total cost of improvements $ h ' 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 he work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subc tors, on work be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. f 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 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 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.
STATE OF FLORIDA,
COUNTY OF DADE. ss
Disapproved � z Date
(Signed)
Building Inspec 4r
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. ..J,
Registered Architect and /or Engineer
Name and address of licensed contractor L! fleAlAve.
Location and legal description f tp lib
Lot __ ems- I' f `� loc
Street and Number where work is to be done
State work to be done and purpose of building (by floors)_..
Date
Subdivision. "_�_!./
No 'l o (/__ Street • - t c o - T
t and for no other purpose.
New Building__. �1 Rernodeling. Addition v Repairs No. of Stories
To he constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $ J •yrN e
Zone cubage required _Plan Cubage r0,2..a.✓ , ' :/ 6J/I c !� iya �h e ice- ° ,
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 • the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such bcontractors, on wor t. . - performed under this
permit, as are licensed by Miami Shores Village.
Remarks. (Signed
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 2 .. Date 1 — � ' ° Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
LANNING 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
cey
6770 x o
12
( 3
Permit No Z�
Application is hereby made for the approval of the detailed statement of the plans and specificatio•: erewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Build' Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and a 1 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 work.
STATE OF FLORIDA, }
COUNTY OP DADE.
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL P RMIT
rr-- 0
6 3.
MIAMI SHORES VILLAGE
Owner's Name and Address
Registered Architect and /or 4. 'nee/
Employing Electrician's Name. ; .. No95 _ ...' u"'itreet C��Y•
Location and Legal Descri. ' Lot 3 v Block Subdiv' on
Street and Number where work is to be performed —No
90 /v.
New Building Remodeling Addition
/ '
State work to be performed and purpose of building (By Floors)
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ / (Signed)
(Signed
No Street
Repairs No, of Stories
The undersigned applicant for this building permit • does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub•co on work to
licensed by Miami' Shores Village.
Da
Street
" Inspector.
ccepts his Igations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the ork such public notice or notices
be , performed under this permit, as are
Master Electrician.
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, and 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 necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
HATER
STRIP
HEATER
TOTAL
CONTR.
LIST
/3
/
//
i/
13
,1
V
CHECK
V
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
-
( 3
Permit No Z�
Application is hereby made for the approval of the detailed statement of the plans and specificatio•: erewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Build' Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and a 1 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 work.
STATE OF FLORIDA, }
COUNTY OP DADE.
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL P RMIT
rr-- 0
6 3.
MIAMI SHORES VILLAGE
Owner's Name and Address
Registered Architect and /or 4. 'nee/
Employing Electrician's Name. ; .. No95 _ ...' u"'itreet C��Y•
Location and Legal Descri. ' Lot 3 v Block Subdiv' on
Street and Number where work is to be performed —No
90 /v.
New Building Remodeling Addition
/ '
State work to be performed and purpose of building (By Floors)
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ / (Signed)
(Signed
No Street
Repairs No, of Stories
The undersigned applicant for this building permit • does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub•co on work to
licensed by Miami' Shores Village.
Da
Street
" Inspector.
ccepts his Igations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the ork such public notice or notices
be , performed under this permit, as are
Master Electrician.
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, and 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 $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CI h$eTf
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBB
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NB
TOTAL
FIXTURES
--
CONTR.
LIFT � �� --
CHICK
/
.
�,
SEPTIC
TANK
SEWER
CONN.
DRAIN.
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
— CONTR.
LIST
/
/
CHICK
Permit No._
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City — Well. ______:
Amount of Permit $ ----------
we'
0
/
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application is hereby nw de 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 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 work.
Owner's Name and Address S ____!_ asAP `_-------------- ••--- - - - - -- No. Street
Registered Architect and /or Engineer_____________________
Employing Plumber's Name , A/61 , Va � No.________— ________ Street- -__
Location and Legal Description Lot__._.._.._.____ ____ -______________ Block_ Subdivision
Street and Number where work is t� be performed —No._ 70 lo O Street
State work to be performed and purpose of building (By Floors)
New Building _ Remodeling_ Addition_
Repairs
- 5 /7_ -'
No. of Stories.
Type of Tank
(Signed)
(Signed).
Capacity Gals.__
.__Dist. Feet of Tank or Drain Field from Well
_Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
umbing Inspec
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent upplement, and leas com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo d 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 work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, ss,
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or work*nanchip.
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.
Date O — —' a ,19
Owner's Name and Address.. � 1�i.� F 3 H, 1i1i1 , No.___7Q__.il.._ Street_...1D4_th._St..
Registered Architect and /or Engineer
Name and address of licensed contractor Brady Roofing Tiles Mfg. Co, - 2955 N. W. 73rd St.
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done. ._ 0 N. E. laatZI__ASt_.
State work to be done and purpose of building (by floors) Roof Addition: 30 - — Tile
and for no other purpose.
New Building Remodeling Addition X Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering Tile
Estimated Total cost of improvements $ 11 .Q5 .00 Amount of Permit $S,00
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 employ
bur under the Florida Workmen's Com I e,
and has complied with the provisions thereof, and will require similar compliance from all contractor or sub - contractors employe
in the work to be performed under this permit; and will post or cause to be posted for ' spection on t�e sit , him
g of the work such prubli notice
or notices as are required by the Act. The undersigned agrees to employ only such spb�ontractor o woJlt tp be performed n dr this
permit, as are licensed by Miami Shores Village. 'r
Remarks (Signed)._
of la P ensation Act, being 5966, Compiled P filed General Laws of Florida Permanent S u
t p c
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowi 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 33 Z- Date -- -- Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Notary Public, State of Florida
Building Inspe tor My Commission Expires
LIANNING BOARD DATE
Chairman Member
V
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.