501 NE 101 St (13)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 the work.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on: n
Lot /34-14 Block f { Subdivision #1 f) `1
9 2 0 /1 / D
Street and Number where work is to be done 7 Z / E / 1 � St'
` .� /v
State work to be done and purpose of building (by floors), state exterior colors (submit samples) C/`� 6� t //9eaU -sze'-i r�
/9eziA1/v s ('Y 7 No , ) vy4 cH,5 — s
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 S ' ����� Amount of Permit S # �
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 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 obligatons 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 empl ly such subcontractors, on work to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Signed) {J
STATE OF FLORIDA
COUNTY OF DADE. } ss.
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 foregoi g application, and that he did sign the same, and that all facts therein by him stated are true.
Permit No. 7zk'l Date \ Read, Sworn to and Subscribed before me.
Disapproved Date
Council Approved
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date .71t 19 2
tr/9dY 5 't F.P4 /4/t LSO /L— No. -56/ Street tip' /d/-
yule . 06,e) ' /4'O cI f
Ow..1E2
Notary Public. State of Florida
(Signed)
Building Inspector "My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Date Disapproved Date
NOTE: A charge of 825.00 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 825.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.
1
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
164.4
E
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 11875
Work to be performed under this Permit
DATE
1,3si At". j
1954__
Contractor's
License No
ovstts
Lot
A;D
"(� Value of
o i s ib Project $
a
This permit is granted to the contractor or builder named above to construct the building or to install the e ' ment or device jdescribed in the application
herefor in strict compliance with all - Ordinances pertaining ereto and with the understanding that the work wi 1 be performed in compliance with any plans,
drawings, statements or specifications that- may have been ubmitted to and approved b} Fie, proper - municipal authorities. This Permit may be revoked at any .
time if the work is not done in compliance with such ord' antes or if the .fans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or bu' er named above : ssumes t
pertaining to the work covered hereby whether shown, on the plans or d :wings o
done by his agents, servants or employees.
Bl.
Subdi-
vision
INSPECTOR
BY
sponsibility for a' thorough knowledge of the ordinances and regulations
e statements a specifications and t. t he assumes responsibility foL3gork
In consideration of the issuance to me of this permit I agree erform` the " ork covered here in compliance ; th all ordinances and'" gt lations
pertaining t " nd in strict conformity with the plans, drawings, stateme ' : or sp submitted to the proper au : orities of Miami Shore Village.
In accepting . it assume res on lity for all work done by eithe + self my agent, seant or employee.
Amt. of
Permit $
AUTHORITY