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810 NE 100 St (11)MIAMI SI-00 BUILDING INSPECTION DEPARTMENT APPLICATION FOR IJILDING 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 shalt 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. 5-.22._ ., 19 72 Owner's Name and Address W . ST0P1?ACCr No Street_ Registered Architect and/or Engineer Name and address of licensed contractor Q.k...13.95.;..K., 7E 14 (-4- 7 — S St Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done SI 11E- _Loo s` State work to be done and purpose of building (by floors) 1 1+1.S7CR .4 I _ J C i P (=LT D /2c77/410124 7T e. New Building Remodeling To be constructed of Kind of foundation _ o o Estimated Total cost of improvements $ Zone cubage required Addition ES VILLAGE Repairs No. of Stories ring Amount of Permit 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, Pennanent 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 subcontrac rs, on,wtko be performed Under this permit, as are licensed by Miami Shores Village. Remarks._ (Signed 1 3- `1 1 GO S and for no other purpose. 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. Permit No—../.4..`te 7 Date C:1 7 z_ Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Notary Public, State of Florida („SR 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 51.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. 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 _5: - 2 , 19..72 Owners Name and Address__-- Wt,,,TA n No. Street Registered Architect and /or Engineer Name and address of licensed contractor z:-E:'- _ Z?: Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done _ . d kf.t State work to be done and purpose of building (by floors) _ ■ C7CL I (4)012e -- • - f3flc and for no other purpose. New Building Remodel n1r Addttt i Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ jU z3 _�� Amount of Permit $ Zone cubage required _Plan Cubage Size of Building Lot 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. 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 inspe• ion on of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontr .� ors, n wor o be performed under this permit, as are licensed by Miami Shores Village. Remarks (Sign 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 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. Owner of Building Architect Contractor or Builder Legal Description Address of Building 4,1 Lot fa . MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ PERMIT N9 PLUMBING ❑ N. 8 0 5 7 ROOFING � ❑ r, . + Si. yf ?f1' =�C CONTRACT OR BUILDER Contractor's License No -- Work to be performed under this Permit f,E Subdi- vision • Sq. Ft Value of Project BY DATE ' , f 195 Amt. of Permit $ AUTHORITY 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 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 responsibility for work done by his agents, servants or employees. Signed. �r� # .e' . e 4 BY ''INSSCCTOR 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 pecifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either( ' itf�ff,,my aggent�se� rant or employee. 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._ Registered Architect and /or En !leer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision -_ -_ L Street and Number where work is to be done IP_.__ _._I St work to be STATE OF FLORIDA, COUNTY OF DADE. ss e and pur•::e to b- 'lding (by floors). New Building To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Addition Repairs No. of Stories MIAMI SHORES VILLAGE Date / f /L No P !o Street n 1O Q < T• 7 / 04 16 and for no other purpose. 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 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 a 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 ' "tractors, .ction on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such �: -. on work to b- perfor •ed under is ■ permit, as are licensed by Miami Shores Village. � Remarks ( Signe ., 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 s are true. / 11 Permit No t � 5 Date___ 1 / / f .7Read Sworn to and Subscribed before me. Disapproved (Signed) _ Building Inspector My Commission Expires PLANNING BOARD DATE Chainnan 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. Notary Public, State of Florida