565 NE 101 St (12)BUILDING
ELECTRICAL
PLUMBING
Contractor
or Builder
CONTRACTOR OR $1JI11i15ER
I
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N. 3388
Work to be performed under this Permit
Owner of t' a
Building
Architect 1 .
Subdi-
vision
Value of
Project
DATE
Contractor's
License No.
WARNING: ! s Construction may be In violation of
War Production Board General I imitations (lydor I .41
You are cautioned to consult your War Production
Board office before starting the work authorized in
this permit.
T 194.
Legal Lot C. Bl.
Description
Address of rf ..• t
Building +-r" C f"
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 stricticompliance 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 d ;wings or in the statements or spe cifi {atios and
that he assumes responsibil for work done by his agents, servants or employees. „f; ' n
Signed• ttw.. i By • r 0',/1 . r
°INSPECTOR
Amt. of ,,s
Permit
In consideration of the issuance to me of this permit I agree to perform the work coveted hereunder in compliance with all ordinances and regula-
tions pertaining thereto add in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities; of Miami Shores
Village.:, In accepting this perii t I assume responsibility for all work done by either myself, my agent, servant or employee.
New Building
STATE OF FLORIDA,
COUNTY OF DADE.
Permit No
Disapproved
(Signed) _.
Chairman
Member
Member
Council Approved
MIAMI SHORES VILLAGE
BUILDING INSPECTION 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 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 regula-
tions 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_ - -- / -- — — — —
Owner's Name and Address I � 6 No c!? Street —_ e / 6 /
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
—_ Block_ _ Subdivision ' ate ar t-
Street and Number where work is to be done .L / / r
State work to be done and purpose of building (by floors)
_ __and for no other purpose.
Remodeling____ —__ Addition____ — __________ Repairs No. of Stories__
Building Inspector
To be constructed of_____— ___— _______ Kind of foundation
Date
Date
Roof Covering
Estimated Total cost of improvements $ F°' ______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
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 to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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 be did sign the same, and that all facts
therein by him stated are true.
Read, Sworn to an b scribee,befo{e me.
Notary Public, Stat
My Commission Expires
PLANNING BOARD DATE
Member
Member
Member
Date Disapproved
- 3
19 t y
to me well known,
_Date
NOTE: A charge of $1.00 will e 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.
4
Street and Number where work is to be done
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
BUILDING INSPECTION 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 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 regula-
tions 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 . er
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot___ — —_ —_ —_ Block__ e / Subdivision
State work to be done and purpose of building (by floors)
Date_
Permit No. Date Read, Sworn to and, Subscribed before me.
Disapproved ____________ _ Date Notary o724--
------------ r_..�. �.
ry Public, State f`
(Signed) -- — — —
Building Inspector My Commission Expires_ —__—__
Li c
_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 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
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 to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
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.
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member -
Council Approved Date Disapproved
NOTE: A charge of $1.00 will be matte 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.
—Date