848 NE 100 St (14)BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
Application is hereby wade 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 shill 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
State work to be done and purpose of building (by floors)
Permit No._
Disapproved / ^l/ r `
(Signed) 1
MIAMI SHORES VILLAGE
Date / 2 Z
Building I
e
H.I. Cox — N 843 S 100th Street
Registered Architect and /or Engineer ,,,, ,,,,,,,,,,,,,,,, ,,... - -.
Name and address of licensed contractor AaaMETIC TANK 2ERVICE 4123 N, X, 54th Street
Location and legal description of lot to be built on:
Lot Block Subdivision Q
Street and Number where work is to be done g44t-.JL E.. -1D4th.. ameat
_-
32' drainfield relay
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $.
Zone cubage required _Plan Cubagg
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 worjs to be performed under this
pennit, as are licensed by Miami Shores Village.
Remarks._._ (Signed)
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 - —
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.
?
Read, Sworn to and Subscribed before me.
to me well known,
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD _.._ DATE
Chairman Member. .
Member Member
Member ...... _ Member ...._
Council Approved Date Disapproved
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the Planning Board.
A re inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice
materials and /or workmanship.
Date
has been obtained froth
for inspection or faulty
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at .
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer .....
___.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-- ---- -- ---- --
Employing Plumber's Nameil_1_l_ t'!! —_ _ C#7 e_ ;
Location and Legal Description Lot - - - - -_ ---- _ - - - --
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By ..... !k L Q$ 11.
New Building __— Remodeling____ — _._._ Addition
Amount of Permit $
T_
_ - --_ -._ No.___.__L.Z.'_ T Street_' ET I D 0 S7
Nl� No.-- --- _7-6
Block
_. �_-- ----- --- -.. Subdivision - -- - --- --
-13 Street. N E / 1067
AeF, Ea 2413LO
Size Septic Tank _..__ Type of Tank__ Capacity Gals
Feet of Drain Tile .... ___________ _______________________.__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — — — ___. _Size of Soakage Pit
( Signed) _
Plumbing Inspector.
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 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor ployed by him in the work to be
public notice or notices as are
erformed under this permit, as are
performed under this permit; and will post or cause to be posted for inspection on the site of the wor
required by die Act. The undersigned agrees to employ only such sub-contractors work to
licensed by Miami Shores Village.
Si
Date
Repairs No. of Stories
My Commission Expires Notary Public, State of Florida
Street___Q' 6
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
INK
SLOP
SINKS
LAUNDRY
TUBE
U
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKI NG
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IN '0
POOL
CONTR.
LIST
CHECK
...
t
I
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at .
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer .....
___.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-- ---- -- ---- --
Employing Plumber's Nameil_1_l_ t'!! —_ _ C#7 e_ ;
Location and Legal Description Lot - - - - -_ ---- _ - - - --
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By ..... !k L Q$ 11.
New Building __— Remodeling____ — _._._ Addition
Amount of Permit $
T_
_ - --_ -._ No.___.__L.Z.'_ T Street_' ET I D 0 S7
Nl� No.-- --- _7-6
Block
_. �_-- ----- --- -.. Subdivision - -- - --- --
-13 Street. N E / 1067
AeF, Ea 2413LO
Size Septic Tank _..__ Type of Tank__ Capacity Gals
Feet of Drain Tile .... ___________ _______________________.__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — — — ___. _Size of Soakage Pit
( Signed) _
Plumbing Inspector.
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 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor ployed by him in the work to be
public notice or notices as are
erformed under this permit, as are
performed under this permit; and will post or cause to be posted for inspection on the site of the wor
required by die Act. The undersigned agrees to employ only such sub-contractors work to
licensed by Miami Shores Village.
Si
Date
Repairs No. of Stories
My Commission Expires Notary Public, State of Florida
Street___Q' 6
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
I
BUILDING
ELECTRICAL I PERMIT N? 11852
PLUMBING
Owner of
Building
x
ROOFING (l Work to be performed under this Permit
WIZ e
Architect 14. U V 4 t t 'nt
o�Bu Builder
R McwakOS.K.: Y
�g� r4 L #t 1, �/1 B1.
Descriptio l� ( �,(�I
Address of , T - E ' I I
Building C,/1
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE
6+
Subdi-
vision
Value of
Project $
BY
F'z-s"'i
195
Contractor's
License No
Amt. of
Permit
24‘000
W 40004.
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 • it * q• Ct BY o /
INSPECTOR
Ci
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
:pgrtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
InNaccepting this permit I ssii n responsib)ity for all work done by either, myself, my agent, servant or employee.
s. 1
AUTHORITY