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361 NE 101 StMIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed statc,.u•nr or tore plans and specifications herewith submitted for the build • or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami ,sore's Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and egulations 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 .... I Registered Architect and /or Engineer Name and address of licensed contractor Estimated Total cost of improvements $ fL ?co • STATE OF FLORIDA, 1 . COUNTY OF DADE. J ss. peared Disapproved (Signed) Building Inspector AL NOTE: A charge of $1.00 will be made for the Planning Board. A re• inspection fee of 51.00 will be charged materials anti /or workmanship. .Chairman Member Member .. .. Council Approved 51 f. z...... 1 " ®Oo Q PLANNING BOARD DATE D ate .../.t.l /Z �s .� ..._�_..._._.�.._.... ,19 Location and legal description of lot to be built on: L o t . / . Z r r . . .0/ ` ' P.) Block 3 Subdivision i ! � • , S - I - 1 62e2, _.. a C' C r 4'1 Street and Number where work is to be done 3 / _... G_ r .l.. __ �- State ork to be done and purpose of building (by floors) R 'ttliar 6.1 .a L CO 5e re Q and for no other purpose. 1.... ? street_..1 O L pll. !ll••• ,,,•,lul.11!llll.. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Amount of Permit 5,.. ,.9b �.. 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 ‘Vorkinen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the rovisions 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 arc required by the Act. The undersigned agrees to employ only suds subcontractors, on wgyk-to under this permit. as are licensed by Miami Shores Village. r J Remarks (Signed) Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- 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 (e_120 Date - - 5-$1 Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires __.._..._.._..�. _ _. Member Member Member ...._ — Date Disapproved Date making corrections or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection oe faulty 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. �{ �'� Z /; � iJ / Date / 0 ,1§2. _ Owner's Name and Address. ✓. 1 6 ' ° a `� „ i / JZ' No ? P / Street N. g - id/ 5 7 — Registered Architect and /or Engineer pp > Name and address of licensed contractor 6'19 r” -9' - � C' C 'H Location and legal description of lot to be built on: Lot Block Subdivision ,. Street and Number where work is to be done 6/ Al ( 1 .1 SI State work to be done and purpose of building (by floors) /J' 7 Q 'Psi Wes _ d�t.K' .....__r ( 1.t ,s .,.-A'.1..1.�3t.L t „ LQ9 )4. kko._P 4 ` l 4 6 New Building Remodeling •' Addition Repairs &� No. of Stories i To be constructed of Kind of foundation Ro Covering Estimated Total cost of improvements $ l' 4 mount 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 s be ntractors, on work to be per rmed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) Date r 4(4) Permit No Disapproved , � " Dat (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Building Insp- or PLANNING BOARD Read, Sworn to and Subscribed before me. DATE and for no other purpose. 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 red the foregoing application, and that he did sign the same, and that all facts therein by him stated ar tru Notary Public, State of Florida My Commission Expires 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 ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot k, ' MIAMI SHORES VILLAGE. FLORIDA ° PERMIT N? 9144 / . is 1 -'y CONTRACTOR OR BUILDER J• i Bi. Work to be performed under this 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 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: Subdi- vision Sq. Ft Value of Project $ i DATE Contractor's License No r Amt. of Permit $ BY AUTHORITY 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. 'OM*" " APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the 1 ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi. Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules at 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 ein el _ i e , 19_ Owner's Name and Address ' I. A Nol Stree �� G � r Registered Architect and /or Engineer Name and address of licensed contractor Build , g Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT PLANNING BOARD Location and legal description of lot to be built on: s ; 14 Lot 1' ° t' ' r 2 '`�17_ Block Subdivision___ , 41 --7 Street and Number where work is to be done 3-6 / ti - _ /0 i _ State work to be done and purpose of building (by floors) r and for no other purpose. New Building Remodeling Addition Repairs No. of Stories____ To be constructed of Kind of fo ndation Roof Covering Estimated Total cost of improvements $ 4 ® ® 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, % work to be performed under this permit, a licensed by Miami Shores Villa e. Remarks_ Ir. � ,� c3 1 f w a eia t -0. ' ed i % i ce L= STATE OF FLORIDA, . COUNTY OF DADE. ss. Before me, the under 'gned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me f st duly .worn, upo oath deposes and says at he is the of the above described nstruc on, that he has carefully dead the regoing application, and that he did sign the same, and that all facts therein by him stated ar Permit No.__ - Dnsapprevecb -_- , - k Notary Public, State of Florida ( Signed) My Commission Expires Read, Sworn to and Subscribed before me. 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.