350 NE 101 St (3)BUILDING
ELECTRICAL
PLUMBING
ROOFING
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Owner of
Building e / I�
D
LI
PERMIT
Architect
Contractor /4* fy or Builder (r 63" • �
A . - / 1
Legal Lot
Description 11 Bl
•
MIAMI SHORES VILLAGE, FLORIDA
DATE
N9 6498
Work to be performed under this Permit
z f /l e t
19 ' ;
Contractor's 7 f O j
License No.
Subdi-
vision
f?
Address of . - ' Value of I Amount of
Building 4 c- � f / ` t ` P roiect $ ? 0 I 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 prthe ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifieations and t t he assumes respon-
sibility for work done by his agents, servants or employees. / /
( f ,
Signed. �e'" '�' INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compli¢h = with all ordinances aft • ,regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the propeV orities of Miami Shores Villa In as
cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee.
r f' ( �.
I CONTRACTOR OR BUILIR BY ,
AUTHORITY
AttOT
f
(Signed)
Disapproved je' Date
MIAMI SHORES VILLAGE
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.
BUILDING INSPECTION DEPARTMENT
_ Date 6 Owner's Name and Address___ 44 c 0 6e No • ® Street
Registered Architect and /or Engineer /c`
Name and address of licensed contractor____ .4-4.--.6 ® P n /W n t , ri t / 0 CL
Location and legal description of lot to be , b �It on:
Lot Block Subdivision
Street and Number where work is to be done qq f
State work to 13e done and purpose of building (by floors)_ ___. _ l�f Q Is _ ._P_J_ A n� � - t. c ,�.?
n n/ 2 o
o �=d C De cJ h CXJ e �L9 p-L_'c� c v o — (ryr, ��.�_ '7 & . Gl c4 d �!
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roo Covering
Estimated Total cost of improvements $ <-3 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 o work such public notice
or. notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on wo to b performed under this
permit, as are licensed by Miami Shores Village.
Remarks -- — ( Signed) � � - %i/4.,4
STATE OF FLORIDA,
COUNTY OF DADE. j 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
till therein by him stated are t
Permit No 1 Date CS Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspect; My Commission Expires
P. /ANNING 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.
Lot(s)
p
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub-
mitted for the building or other structure herein described. This application is made in compliance and conformity with
the Building Ordinance of the City of Coral Gables, Florida. All provisions of the Laws of the State of Florida, all ordi-
nances of the City of Coral Gables, and all rules and regulations of the Building Department of the City of Coral Gables
shall be complied with, whether herein specified or not.
OWNER h 66-e-t)
ADDRESS 3S `U £ l 0 ( st
Number of Stories
Number of Units
Type of Roof
Use of Structure
B
Name and Address of Contractor
Sworn to and subscribed before me this_
My commission expires:
A
APPLICATION FOR BUILDING PERMIT
Block Section
(Signed)
Date 19
Actual
Required
Detached Buildings
SQUARE FOOTAGE
Land Coverage
Actual cu. ft. per front foot
(Commercial Buildings)
Is building within easement area?
Is water available for this building?
Size of Lot x Building $
Setback F FL__ i• FL______ Architect $
Estimated Cost $ Bond No. _
Architect TOTAL $
FEES
MISCELLANEOUS PERMITS: pp►Qo_eo -, L4):071 L, 0-44)
I hereby submit, in duplicate, all the plans an specification: for said building. All notices with reference to the
building and its construction may be sent to
(Ow
or Contractor)
by
STATE OF FLORIDA SS
COUNTY OF DADE
Before me, the undersigned authority, this day personally appeared
to me well known, who being by me first duly sworn, did depose and say as follows:
1. That he is making application for a construction permit for the construction, or repair, of a building in The City
of Coral Gables on the following described premises:
Lot(s) Block Sectio
Street
2. That in connection with the work to be done under such permit no general contractor has been employed or
retained, and no person, firm or corporation, acting as a contractor, is receiving any compensation whatever in connec-
tion with the work to be done under said permit, except:
To be furnished at or before completion of job. (It is understood and agreed
that NO CERTIFICATE of occupancy will be issued until a complete list of all
Contractors who worked on the job has been furnished to the City and unless
all such Contractors had current occupational licenses in Coral Gables.)
that otherwise each person engaged in said construction work is being paid on the basis of a stipulated sum for his
services per day, by the affiant, and that the labor being used in such construction is being done by what is commonly
known as "day labor;" that affiant, as owner, will comply with the Workman's Compensation law of the State, of Florida,
by obtaining a statutory Workmen's Compensation Insurance policy or by qualifying with the Florida Industrial Commis-
sion as a self- Insurer; that the affiant will withhold Social Security Taxes, and Federal and State Unemployment Insur-
ance Taxes, and Federal Income Taxes from wages of all such employees working for him on such construction and
will make returns thereof to the Collector of Internal Revenue, and to any proper State body.
3. That this affidavit is being made by this affiant for the purpose of inducing the City to grant a construction per•
mit and to avoid the payment of the license fee and the deposit of a contractor's bond, as would be required if this affiant
were engaged in the business of erecting or repairthg build tngs in The City of Coral Gables.
day of A.D., 19
NOTARY PUBLIC STATE OF FLORIDA
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