94 NE 100 St (14)MIAMI SHORES VILA_
BUILDING INSPECTION DEPARTMEN
APPLICATION FOR BUILDING APPL! RMIT
Application is hereby made for the approyal 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.
•
Ownees Name and Address .1001 ej „... , t/`�/ y r r /� � / No._Y'4 ,« Str t,_LOO aT •
Date�L... l9 7�.
11E:giiteud Aftliit631 tilid /tl{ nigitietlY:: 111 9^``, T"ais 1213311 41 I • zie91.416.114f, ttttttttttttttttttttttttt • /,„
Name and address of licensed contractors/0.60,0404 O #$ • Lb. SIC • LOL..�& /AS .. S'7
Location and legal description of lot to be built on;
Lot.. ro A��de Block. 9 Subdivision_ILIA ed.ptiOIJt'r /y0,
S eet a n d \ ber where work is to be done. .94 E. /M P �T• /Viiilfriv I e SAW: g
State work to be done and purpose of building (by floors) 4241!0/200 r /ON —21P r
eizetri
and for no other purpose.
New Buil ding ......._...._ ............... Remodeling.: ....... Addition... Repairs.
To be constructed of. /fCr. r ..4 Kind of foundation- _. !!'!C •
Estimated Total cost of improvements $.41i .__.....— ._.....___.._Amount of Permit $
Zone cubage required �__..._........_ plan Cubage
Distance to next nearest building...... _ _ Size of Building Lot
Maximum live load to be borne by cach floor...
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may •
Disapproved .__. g ._¢ . . Date
(Signed)
Chairman ._......._..
Member ..._.._....
Member
Council Approved
PLANN t OARD_ . _...... DATE
�____. -• —_
...... Member
Member
Member
--
— Date
___ No. of Stories • t
•
Roof Covering.. i WI.Ilit _ '
be sent to.fi. ■#9 4QCL .. COR107 . £ . /AV. . /QQ/ .. �:.... / £ 17
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 hint
in the wort; - 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 to be performed under this -
permit, as are licensed by Miami Shores Village. SA4'R�•O�GOiver•CO IAA
Remarks.. _ ._. (Signed)_._.
Notary Public, State of Florida
Building Inspector Z� �GImmission Expires
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-
peased
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. t 7 S
Read, Sworn to and Subscribed before me.
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.
materials and /or workmanship. re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for iospectiaa or faulty
manship.
.
r °#"/
/- a -
Lot Block Subdivision
�Q /,7�'� •
Owner's Name Lic.No.
Genera Contractor Lic.No.
Zone Req.Cu.Ft.
Plat Restriction Checked by
To Planning Board
Re- Submitted to P.B. Approved
Plans & Spec. Checked by
To Council Approved
Bldg. Permit No. Date
Type c ,/ d •
New Construction
Plumbing Permit No.
Septic Tank
Sewer
Phis c' 1
New Const.
'Electrical Permit No.
Fixtures
Heater
Motors
New Construction
Building Inspection
Foundation
Beams & Lintels
Final
Final Clean -Up
P lumbing Inspection
Roughing
Fixtures
Sower
Septic Tank
Solar Heater
Final Certificate
n ecbrical Inspec ion
Roughing
Fixtures
Final
Tempo O.K.
;Service O.K. to Power
[d 0p
r
/Opel Vr'
V
Rejected
/
` A � Fee / ° G Cost /‘ 70 ,e)
o
Stories _ 1 Roof o s Z •
Alterations
Alteration
Date
R
H
n
r 11
Alteration
D to ' By
/4
)000/ -By-
aim /
1 0
By
Date
11
11
11
a
Co. 4 /0d 0 !
G
Cu. Cont . Ga 4 ',
C, A / 4
qy) f 7
Fee
n
11
11
Re •airs
Fee
-- 9
n
11
11
Repairs
No. Street
Add. or Phone
Add. or Phone
Approved Rejected
Repairs
Rejected
Rey -insp By Re -Insp By
Re -insp By Re-Insp By
Re -insp By Re -Insp By
Cert.Occup.Issued