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358 NE 101 St (2)f / �, - OWNER'S NAME l G i4 2. Al TYPE C S 3 4 - 8 PRESENT ADDRESS /I-6. / 0 1 — I - 7 - LICENSE NO. PHONE NO. 3 4 7 8 JOB LOCATION (ST. OR AVE.) /I- 4 N. ®o/ "6Jr LOT ( * $ e 4 BLOCK SUBDIVISION !-11 aii re s &c...1 / SUBMITTED TO PLANNING BOARD GENERAL CONTRACTOR s /4ii.444$ 4/17 C„r ADDRES 6 N �' 7 PHONE NO. LICENSE NO. I , �y! BUILDING PERMIT NO. T 4 7 7 f� DATE " / L 4 PERMIT FEE $ / BUILDER'S BOND NO. DATE ZONE i r i c.0 - - REQUIREMENTS CU. FT. 3 'y.- 0, L-1.2., = -zc _ 13 PLAN CUBE e, .. CU. FT. 0 0 EST. COST $ da ®4:) r DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: C.. tk • BUILDING PERMIT AND INSPECTION RECORD — MIAMI SHORES VILLAGE I DATE Y Imo_ e, NEW CONSTRUCTION TYPE C S STORIES O et, e. ROOF CONSTRUCTION \�,.°T' op INTERIOR CONSTRUCTION FC 1 ■ D(A (3A M. APO REPAIRS DESCRIPTION ( ,, r .0 "''r' 42_,/ (' 0- Z Z. 0 ( .-5 / 4' 1 INA C2. / 2. 4 e s-a a x� C es._ 0 c ect, DESCRIPTION ALTERATION / L �a'-S .( ADDITION 4.3e.6 e, (9 _ t `/\ vas --.--- SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTFD TO VILLAGE COUNCIL REMARKS / CERTIFICATE OF OCCUPANCY NO. 1+2- I ISSUED /r fr (' 3 ��/f ! BY '• "'> {,!/ TO / /'�/ COQ' .9-Lel DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: C.. tk • BUILDING PERMIT AND INSPECTION RECORD — MIAMI SHORES VILLAGE I DATE Y Imo_ e, INSPECTIONS DATE BY INSPECTIONS DATE BY FOUNDATION y�32"-y' `' ROOF €t-30 -d e_.tiG. , BEAMS & LINTELS o- 8 Y"' - k.6 POOL SOLAR HEATER $ FRAMING `6'3'-' .3 e., "45 AIR COND. MOTORS $ FINAL $ FIXTURES CLEAN UP INSPECTIONS ) '' t. S. SLAB C S , v'� C "30l(5 RE - INSPECT BY ROUGHING SLAB SPECIALS PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE REPAIRS SPECIAL PERMITS $ SEPTIC TANK FEE TEMPORARY SERVICE $ SEWER $ H. W. HEATER CONN. $ SOLAR HEATER $ RANGE CONN. $ GAS $ MOTORS $ $ FIXTURES $ INSPECTIONS DATE BY RE- INSPECT BY RE - INSPECT BY ROUGHING TUB & TOP OUT SEWER SEPTIC TANK SOLAR HEATER FIXTURES GAS CONTRACTOR PHONE PERMIT NO. 1 DATE FEE $ NEW BLDG. I ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE ROUGHING $ H. W. HEATER CONN. $ RANGE CONN. RANGE CONN. $ MOTORS $ FIXTURES $ FIXTURES & FINAL III I b / ' ; d $ INSPECTIONS DATE BY RE- INSPECT BY RE - INSPECTI BY TEMP. SERVICE ROUGHING y( - ? L{ ::.�S6 H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL III I b / ' ; d F ie. BUILDING INSPECTIONS CONTRACTOR PERMIT NO. NEW BLDG. PLUMBING PERMITS & INSPECTIONS DATE 1 ALTERATION 1 ADDITION PHONE FEE $ REPAIRS . APPROVAL TO POWER CO. FOR SERVICE DATE BY 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 - r7 Registered Architect and /or Engineer Name and address of licensed contractor_. Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 3 _� (? r • State work to be done and purpose of building (by floors) Disapproved , Date_ (Signed) _ Building Insper Date° — ® ,, 19 No 3 � A�_ Street / ® S Y . and for no other purpose. New Building Remodeling Addition L. Repairs No. of Stories. p > _gyp To be constructed of K' K. ,,,. f foundation.._ Roof Coverin 4i — teC9- Estimated Total cost of improvements $ 7,0,1 �' 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 the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work t be performed under permit, as are licensed by Miami Shores Village. Remarks (Signed) O Notary Public, State of Florida 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 �4? edsttated are true. S Permit No S Date v � Read, Sworn to and Subscribed before me. 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 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 ® / / 19 Owner's Name and Address._.. jl-. -. -__ • � _r / .j No S s' 0s Street /0 / 4 , Registered Architect and /or Engineer 3 � 2 Name and address of licensed contractor / <' .A Location and legal descripti n of lot to be built on: Lot / /Z..6,/ � Block 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 of.__Ce__Ga o .. Kind of foundation "o e Estimated Total cost of improvements $ .15° Zone cubage required Distance to next nearest building Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. be sent to Permit No Disapproved (Signed) Building Infector MIAMI SHORES VILLAGE Date. __ a.° t 0 Subdivision / _k2. v SfYQ e r, s , � e • lad f • syy. C d,'..S. Afl, • and for no other purpose. Addition f° Repairs No. of Stories Roof eCoring e / d A ou of Permit � $ (/-f_._�/ .Pjin ubage %I Z. �/ . . t 2,6651 2,6651 V Building Lot.. ` y . PLANNING BOARD DATE 6 ,7.P/ A' /,V1., 77 . 'J Read, Sworn to and Subscribed before me. re) 4 o._ 11 notices with reference to the building and its construction may 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 subcontractgr on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) 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 true. Notary Public, State of Florida My Commission Expires Chainnan a 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. '41;4"-.A c/^/74(c,...).= A7 ,ro i , 0 0 3