825 NE 100 St (8)OWNER'S NAME
PA IAA.% �vA on. e V t�.`4. c:.��
PRESENT ADDRESS
loo 0o ?J-`- `'� /Lug .
LICENSE NO.
PHONE NO.
JOB LOCATION (ST. OR AVE.)
a 4 1U • C l Om � `%*.
LOT /' /i
•�..+i Se. e . ea G.
BLOCK
(1 : r / e IAtyro,
I SUBDIVISION
GENERAL CONTRACTOR
? v4,. s. 2.7,cli
ADDRESS
F3 ,IC. .5,,, / 4•9.
_
PHONE NO.
LICENSE NO.
BUILDING PERMIT NO. /
DATE Z -i4'-
PERMIT FEE $ No C O.
BUILDER'S BOND
NO. DATE
ZONE REQUIREMENTS CU. FT.
PLAN CUBE CU. FT.
EST. COST $
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: 01- 74.0
/ .
DAT=
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
NEW CONSTRUCTION
TYPE
6 S
STORIES
ova
ROOF CONSTRUCTION
11/e .
INTERIOR CONSTRUCTION
C'•-. S Y.-P c. / ik.'o..� capes.
REPAIRS
DESCRIPTION
.�
-• !m / 4- 6 1 . e/'a. 6r a 2a.A. : i 2o F
ALTERATION
DESCRIPTION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING= BOARD
i.
SURM TO VILLAGE COUNCIL
REMARKS
1
CERTIFICATE OF OCCUPANCY NO.
ISSUED
BY
TO
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: 01- 74.0
/ .
DAT=
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
INSPECTIONS
DATE BY
INSPECTIONS
DATE
BY
FOUNDATION
BY
ROOF
SEPTIC TANK
FEE
BEAMS & LINTELS
$
POOL
r
JBdYiL /R
�, �/
FRAMING
SOLAR HEATER
$
AIR COND.
$
GAS
FINAL
MOTORS
$
CLEAN UP
$
FIXTURES
SLAB
SEPTIC TANK
S
SLAB
SOLAR HEATER
SPECIALS PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
RE - INSPECT
BY
$
SEPTIC TANK
FEE
TEMPORARY SERVICE
$
n^
SEWER do 27r/ DAVE"
r
JBdYiL /R
�, �/
$'S"��
SOLAR HEATER
$
RANGE CONN.
$
GAS
SEWER
MOTORS
$
$
FIXTURES
c
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE - INSPECT
BY
ROUGHING
DATE
FEE
TEMPORARY SERVICE
$
TUB & TOP OUT
H. W. HEATER CONN
$
RANGE CONN.
RANGE CONN.
SEWER
MOTORS
$
FIXTURES
SEPTIC TANK
S
SOLAR HEATER
FIXTURES
GAS
CONTRACTOR J_ D. .ECL —Z2( ,
PHONE
/
PERMIT NO. /2,41 I DATE 3- /3—(0/
FEE 5 7 0 �/ 0
NEW BLDG. - u I ALTERATION 1 ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
H. W. HEATER CONN
$
RANGE CONN.
RANGE CONN.
MOTORS
$
FIXTURES
S
INSPECTIONS
DATE
BY
RE- INSPECT BY
RE- INSPECT BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
W .t • Atio 5 F, BUILDING INSPECTIONS 44 ' i
CONTRACTOR
PERMIT NO.
NEW BLDG.
PLUMBING PERMITS & INSPECTIONS
DATE
ALTERATION 1 ADDITION
PHONE
FEE $
REPAIRS
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE
BY
1
MIAMI SH RES VILLAGE
BUILDING INSP CTION 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.. 7 144-4444A: 1 1/ �
Registered Architect and /or Engineer
Name and address of licensed contractor d,Y Q
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
Permit No
Disapproved
(Signed)
Date -2 -' 4 ° ° t
Date
A4 -t.-C-7
Date
eZ�G-
No Street
3 el /dam £'-14'€-.
ate - /7 544- .
y � a
and for no other purpose.
New Building 1 Remodeling Addition Repairs No. of Stories
To be constructed of C-1 S Kind of foundation At. ... Roof Covering -• -- - -I
Estimated Total cost of improvements $ 6.579-0 Amount of Permit $
Zone cubage required Plan Cubage ,,
� .
Size of Building Lot '/ "' L j-
e t A
Distance to next nearest building
Maximum live load to be borne by each floor
I hereby submit all the plans and specific tion f said building. All notices with reference to t e b '!ding and its construction may
be sent to €J — — ` ? 71 - e (. t t '
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 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 o 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.
1'Z."t
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
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.