361 NE 101 St (6)APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed state:,, or ere plans and specifications herewith submitted for the build •
inc 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 Min rni Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must bc kept at building during progress of the work.
Owner's Name and Address . .. / /gPr _ N
Registered Architect and /or l;ngineer
,,,,. .,V..,,,• ,.,,T1H,l ...... ........l,.,,,,
Name and address of licensed contactor. r4 ° �lc.°/'lG/5....1
Location and legal description of lot to be built on:
Lot.../ 9 - a 0 - ff /.. Block Subdivision
Street and Number where work is to be done ,p
State work to be dyne and purpose of building (by floors)...,!_. ,LlilT .,, X�C�C'.l D..l. __ /y Pvt / . , ed,
• ...- on.t .. 'opt' / ee felines / e lea /fe tL.. 641z/it
To be constructed of Kind of foundation
Disapproved Date
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Building Inspector
_........... for no other purpose.
New Building Remodeling Addition Repairs t No. of Stories 1
Roof Covering
Estimated Total cost of improvements $ /1'9- O ' °`� Amount of Permit $.. U CO
Zone cubage required Flan Cubage
Distance .to next nearest building.. Size of Building Lot 23 • ")e J) /
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 Leber under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied %eith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to bc performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice
or noticcs as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to performed nder this
pennit, as are licensed by Miami Shores Village. .
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. i ss'
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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. /�NN Date -q- Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
to me well known,
PLANNING BOARD DATE
Citainnan Member
\Icrr,ber 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 i'Iannir.g 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.
II'IG
ELECTRICAL
PLUMBING
Lot
Work to be performed under this Permit
Owner of
Building J. , ` . -. .,/r . ,, : y
MIAMI SHORES VILLAGE, FLORIDA
Contractor's
License No
PERMIT N? 10646
Architect
Contractor
or Builder
Legal
Description
Address of
Building
M .
Signed•
Subdi-
vision
Value of
Project $
r
Amt. of
Permit $
INS .rt BY
AUTHORITY
•195
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 trpons _
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility or work
done by his agents, servants or employees.
In consideration of the issuance to me of this permit I agrees- . perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity•with plans, drawin "%statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assumefiesp - sibili o all work dq s( by either, myself, my agent, servant or employee. trL
CONTRACTOR t R " BUILDEE/T BY
•
STATE OF FLORIDA,
COUNTY OF DADE. ss.
/ow
MIAMI SHORES VILLACL -.-
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
1
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 Ct — , ° ' 1
Owner's Name and Address __�__ _ Y S �;� No :__4 f Street / / / ' . ° .___
Registered Architect and /or Engineer try I--t. r.
Name and address of licensed contractor
Location 4nd legal description ?
t of lot to be buil on: 3 �
Lo e a ke P _ Block ____ _ Spbdivision__ I a f .
Street and Number where work is to be done / /V 4 / s
Disapproved Date
(Signed)
Notary Public, State of Florida
State work toke done and purpose *building (by ;; floprs )
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation_ - Roof Covering
Estimated Total Lost of improvements $_ _ 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 plan nd specifications for r sai b 'lding. All notices with reference to the building and its construction may
be sent to t --N- -- If _ R- _1 f �� L ot
— — �'y +
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 subco tto onetlC9 to be performed under this
pernnit, as are licensed by Miami Shores Village.
Remarks (Signed) % � tx t ,
_
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.
Building Inspector My Commission Expires
PLANNING BOARD DATE
airman Member
ber Member
4r Member
1 Approved Date Disapproved Date
)TE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
ning Board.
.:-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
and /or workmanship.