BUILDING PERMIT (2)4 .:x. 4i43
Owner's Name and Address
Registered Architect and /or Engineer
MIAMI SHORES VILLAGE
BU .DING INSPECTION DEPARTMENT
APIPL TION 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 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..._ t;l..�,l. - •---- ..__.. �� /� ,19
-s' f //! ... _ No.. ... Street__ -- lf/ // >)T
Name and address of licensed contractor.... ._/�t/L .ZatQs_eei rC�O..! . W /TS J7 s /121
Location and legal descri tion of lot to be built on:
Lot . a` Block �C? Subdivision ,, .cf?/
Street and Number where work is to be done,
State work to be done and purpose • of building (by floors) c -r7.a N .v i?v /z7.ele2 %t1
D2er�a_ ___.L�. ._ /T %la and for no other purpose.
New Building Remodeling 1 Addition ' /�� Repairs No. of Stories
To be constructed of Kind of foundation______ Roof Covering s -
Estimated Total cost of improvements $.._.,Z4..002d , 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 i
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 subcontr rs, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) 0,4--
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
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. I
�_.z '1_G_ Date_ _._..__ / r Read, Sworn to and Subscribed before me.
Disapproved .
(Signed) - � t= ' / -
uilding Inspector
Date
Notary Public, State of Florida
to me well known,
My Commission Expires
PLA j'r G 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 13oard.
A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
� P
•
OWNER'S NAME
Dr. V. M. F14t16.eks+� 4
• PRESENT ADDRESS
444 m .E pc�U `� g
LICENSE NO.
PHONE NO,
JOB LOCATION (ST. OR AVE.)
(Q�, VAJ sT
NA..
4 ° •a. Uez d 4
LOT
6 1
BLOCK-
a7®
1�� SUBDIVISION
t�OC , j L�f Q1J
GENERAL CONTRACTOR
U6c.G_� nr 4
ADDRESS
0G ®Q m.4,) . 0�
PHONE NO.
LICENSE
� / NO.
C.c>cs. l!
BUILDING PERMIT NO. OTC' 4 S
DATE 1¢— 1119
g�,p
PERMIT FEE $ 6a •72®
�.'1
BUILDER•S BOND
NO. DATE
p
►VaI®CgYOC6
ZONE REQUIREMENTS CU. FT.
PLAN CUBE CU. FT.
q
EST. COST $ 6 ' CC1 ',, OoD•
��pp � f.
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: • �• '
`"''�
DATE
61--au'
NEW CONSTRUCTION
TYPE
C. $
STORIES
®pct,°
ROOF CONSTRUCTION
eu� .
INTERIOR CONSTRUCTION
j,�
...g..., ,,D e+ ,,GPC. u `3
REPAIRS
DESCRIPTION /9 OO
p A a n
d.ro -.a ° ‹' 44. y-° & s d 2 O ®� a � clke.a O
ALTERATION
W
6 Cf PTIO
DESCRIPTION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SU TO VILLAGE COUNCIL
REMARKS •
CERTIFICATE OF OCCUPANCY NO.
ISSUED
BY
TO
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
INSPECTIONS
DATE BY
INSPECTIONS
DATE
BY
FOUNDATION
$
1178
ROOF
/2 -1,7 -7O
0S ...o...
«F6.
4100% Pq..N
BEAMS & LINTELS -.1
I'e'IZ7S(0
P•OL
>j - 9 -7
jj - ,zy. 7
I CI,A - ■&s
.3-1,,'
yCC.�ra•
' ° 7..r;`` 5 i
FRAMING I
.A
AIR COND. l 'Z7`is
FINAL I
$
CLEAN UP
GAS
SLAB I
A. lZ7 ZI•
SEWER O.J.V.
$
0.13.5,
tPlb
Ttf C4
�¢.
. t nN
Tnrvl-
SLAB
S
4-1214' Z
SEPTIC TANK
' f :+-- 3 -7 C.
SPECIALS PERMITS PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
BY
RE- INSPECT
$
SEPTIC TANK
DATE
FEE
$
SEWER
$
$
SOLAR HEATER
$
$
GAS
RANGE CONN.
A. lZ7 ZI•
SEWER O.J.V.
$
0.13.5,
tPlb
Ttf C4
�¢.
. t nN
Tnrvl-
$
S
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.
A. lZ7 ZI•
SEWER O.J.V.
II
0.13.5,
tPlb
Ttf C4
�¢.
. t nN
Tnrvl-
$
FIXTURES
4-1214' Z
SEPTIC TANK
' f :+-- 3 -7 C.
SOLAR HEATER
FIXTIIRFS & FINAL
S
FIXTURES
GAS
CONTRACTOR C AeSOt-Y !ir la,c -.� G
PHONE
PERMIT NO. 1 2.1 I DATE ice- I'Z - "f O
FEE $ (.0
NEW BLDG. 1 ALTFRATION I ADDITION •■•
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
H. W. HEATER CONN
$
RANGE CONN.
RANGE CONN.
$
MOTORS
$
FIXTURES
$
FIXTIIRFS & FINAL
S
INSPECTIONS
DATE
BY
RE- INSPECT BY
RE- INSPECT' BY
TFMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTIIRFS & FINAL
BUILDING INSPECTIONS
PERMIT NO.
NEW BLDG.
CONTRACTOR
PLUMBING PERMITS & INSPECTIONS
I DATE
ALTERATION
APPROVAL TO POWER CO. FOR SERVICE DATE
I ADDITION
ELECTRICAL PERMITS & INSPECTIONS
PHONE
FEE $
REPAIRS
BY
ITEMS
SUB CONTRACTORS & SUPPLIEKS
is & ADDRESS
. •Architectural plans
2. Asphalt walks, drives, etc.)
r :_,_ c,/
oi zs
3. Cabinets .- Bath Vanit
,r -
.4. Cabinets ® Kitchen
AAo,vg .
Sea_
5. Cabinets .- Medicine
6. Cabinets ® Unit Closet
o,vE•
/Vo.�L
7. Cleaning
8. Clearin: Site
iN4n4 �
9. Concrete ® Foundation, Slabs. Beams
f=
10. Concrete Walks drives. etc.
11. Contractors Fee
"(, eV
12. Electric Fixtures
(-4.44/c/e
13. Electric Wirin;,
14. Equipment Rental
"_ 4eroAl CZ s7 ,ecc
a .LC
15. Excavation
<=, ,vim
16. Fill for S1
Ajo.c.P •
17, Floors , -Finish wood & kitchen
s�, =-
18. Floors - Terrazzo
________4-&
(7.VG - - fl
-
19. Garage Doors
20. Glass. Sliding Doors °
h 4-2yi .4- r
/{y d,4./^r&
21. Hardware - Finish •
22. Hardware - Rough _
l
23. Heating
, -
24. Insurance - Liabilit •coma-bond
25. Labor Pa o11
•
6. Labor - Contract
-
27. Labor ® Contract
28. Landscaping, Fill 9 Grading
29. Lath Plaster Stucco �
i ..C'
30. Lumber All
L. ,s c 4/,..,G - 2 4 Aa G
31.' Masonry Labor
' SE i
32. Masonry Materials, Block
~s. . Co.vC. Z/2-o Doc Z
33. Millwork
/(o,_.&
• 0
34.. Miscellaneous
35. Ornamental Iron Work
/io,v
36. Oven & Plate - Built -in
ec •..
37. Overhead
t,
38. Painting
,S OZ1= .
39. Permits Temporar, Power
r,6-,e, c
40. Pilin: (Foundation
.'
41 Plumbing Compete
AZ 1. /4,45
e G 6c -c l -
- - - '
42. Pool = Swimmi.ng
43. Roofing & Sh Metal Work
�./s our ,,vim
A,(
•
- •
44. Roof Trusses Pre -fab..
45. Screen Enclosures
t./
•
46. Septic Tank or Sewerage
.
� C, r7c_ /,¢,r/
47. Shower or Tub Enclosures•
,/
48. Steel m Reinforcing & str1.
Sc f-
49. Su ervision •
50. Surveys •
16014,.«
s Zt
51. Tile & Marble +/
52..Water - Public
n4„
53. Water m Well & Pump
/L),IeT
-vie
!
54. Windows - Glazin; & Screens
55. Window Frames m Concrete
"hAr
- Prior to a final inspection this application must he filled out; if sub contractors have
failed to take out permits the general contractor shall be responsible for the permit and
fee. A final inspection . must be made prior to the release to Florida .Power 'and Light Co.
and the issueance of a certificate of occupancy.
OWNER De /l- �'�it/�F� i , � JOB ADDRESS
LOT
BUILDER
BLOCK
SIGNED
CONTRACTOR
11IAMI SHORES VILLAGE
APPLICATION FOR FINAL INSPECTION
SUB.
DAY LABOR CONTRACT DATE
19