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750 NE 101 StOWNER'S NAME FA ..a 4.. Gi E FLV.E. PRESENT ADDRESS - 7 Co t.�. �'. do ( s ST LICENSE NO. PHONE NO. JOB LOCATION • ST. OR AVE.) - u_ N . E. . l o ( S` S ? LOT 1 - 2 BLOCK I 1 o '4 SUBDIVISION H ,, ‘.� Safe - T . . a . GENERAL CONTRACTOR b - .,4. ` ADDRESS SIlw.e PHONE NO. LICENSE NO. BUILDING PERMIT NO. ii 4 O DATE '0 -? 7 O - PERMIT FEE $ BUILDER'S BOND NO. DATE ZONE REQUIREMENTS CU. FT. PLAN CUBE CU. FT. EST. COST $ • O•c•Ct r/� 1 DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY:� . • eaL. �r` ` DATE NEW CONSTRUCTION TYPE Ltt S • STORIES 01 Ke 1 ROOF CONSTRUCTION 'Rave (4 .Ji10 _ INTERIOR CONSTRUCTION On S'•tiel _ e ��P� REPAIRS /'� DESCRIPTION 4 Y� O I _ - Go.. c-d' « C�'Y -. ... • ESCRIPTION ALTERATION ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTEO TO VILLAGE COUNCIL REMARKS a �4 0 m a� CERTIFICATE OF OCCUPANCY NO. ISSUED � 6 BY Ph s , _ 4 . tc (Le. .-- TO BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE INSPECTIONS DATE BY INSPECTIONS DATE BY FOUNDATION SEWER DATE ROOF $ SOLAR HEATER BEAMS & LINTELS $ $ POOL $ FRAMING a AIR COND. MOTORS FINAL 5 FIXTURES CLEAN UP SEPTIC TANK $ SLAB S SOLAR HEATER SLAB - TEMPORARY SERVICE $ SEPTIC TANK BY RE- INSPECT S SEWER DATE FEE $ SOLAR HEATER ROUGHING $ $ GAS $ RANGE CONN. a INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING DATE FEE TEMPORARY SERVICE ROUGHING $ TUB & TOP OUT - IS RANGE CONN. SEWER MOTORS RANGE CONN. 5 FIXTURES SEPTIC TANK $ S SOLAR HEATER FIXTURES & FINAL FIXTURES GAS CONTRACTOR PHONE PERMIT NO. I DATE FEE $ NEW BLDG. I ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE ROUGHING $ H. W. HEATER CONN. IS RANGE CONN. MOTORS RANGE CONN. 5 FIXTURES $ S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL CONTRACTOR PERMIT NO. NEW BLDG. SPECIALS PERMITS BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS PHONE FEE $ REPAIRS I DATE I ALTERATION PERMIT NO. ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE I ADDITION DATE BY FEE OWNER'S NAME 14o,:Aa.,? LA PRESENT ADDRESS i) /so fa•z. lot - �-1 LICENSE NO. PHONE NO, JOB LOCATION (ST. OR AVE.) ( 0.. LOT BLOCK ,� `f DESCRIPTION �ro, A-0C ® ®G' '. a A) A.►.cy # 0 P 0 A ° 02 , cox 'eta,-! 4 t .a: SUBDIVISION GENERAL CONTRACTOR ADDRESS �q O PHONE NO. LICENSE NO. BUILDING PERMIT NO. I ® ■ S DATE ‘ �`Z •D PERMIT FEE $ I ®"" BUILDER'S BOND NO. DATE ZONE REQUIREMENTS CU. FT. I PLAN CUBE - 2 `L',.1 C) CU. FT. EST. COST %.4.00 2 • DRAW NGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: • • BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE DATE NEW CONSTRUCTION TYPE STORIES ROOF CONSTR TION INTERIOR CONSTRUCTION REPAIRS ,� `f DESCRIPTION �ro, A-0C ® ®G' '. a A) A.►.cy # 0 P 0 A ° 02 , cox 'eta,-! 4 t .a: ALTERATION DESCRIPTION ` ADDITION C:•, tel 1 \ m SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL . REASONS RE- SUBMITTED TO PLANNING BOARD SU'BMITTFO TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. / 7 0 7 ISSUED 3 � BY -- TO ' -' _� = ". � �� ..• 2 • DRAW NGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: • • BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE DATE INSPECTIONS DATE BY INSPECTIONS DATE BY FOUNDATION I $ ROOF FEE TEMPORARY SERVICE BEAMS & LINTELS SEWER POOL TUB & TOP OUT $ FRAMING I $ AIR COND. $ GAS FINAL MOTORS $ CLEAN UP $ FIXTURES SLAB SEPTIC TANK $ FIXTURES & FINAL SLAB SOLAR HEATER SPECIALS PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE RE- INSPECT BY $ SEPTIC TANK FEE TEMPORARY SERVICE $ SEWER $ TUB & TOP OUT $ SOLAR HEATER $ RANGE CONN. $ GAS SEWER MOTORS $ $ FIXTURES $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING DATE FEE TEMPORARY SERVICE $ TUB & TOP OUT H. W. HF_ATER CONN $ RANGE CONN. RANGE CONN. SEWER MOTORS $ FIXTURES SEPTIC TANK $ FIXTURES & FINAL $ SOLAR HEATER FIXTURES GAS CONTRACTOR ra , se p Q , PHONE PERMIT NO. I ( DATE II ��- Its-)Fa FEE S REPAIRS NEW BLDG. I ALTERATION f I ADDITION SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. H. W. HF_ATER CONN $ RANGE CONN. RANGE CONN. $ MOTORS $ FIXTURES $ FIXTURES & FINAL $ INSPECTIONS DATE BY RE- INSPECTI BY RE- INSPECT BY TEMP. SERVICE • ROUGHING H. W. HF_ATER CONN RANGE CONN. FIXTURES & FINAL a BUILDING INSPECTIONS i t *! CONTRACTOR PERMIT NO. NEW BLDG. PLUMBING PERMITS & INSPECTIONS I DATE I ALTERATION I ADDITION ELECTRICAL PERMITS & INSPECTIONS PHONE FEE $ REPAIRS APPROVAL TO POWER CO. FOR SERVICE DATE BY 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 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. OwneF s Name and Address . PUL G. EG _ ..._ _ N o . . . . . . . . . . . Street-0'E' Ml t (. M b t. 4:. (�E� - - , G , Registered Architect and /or Engineer C''-. « e,�.a ,t, `� � _,... , � ,.. ,,,.,,_ -. ... Name and a d css of licensed contactor n �N LtSt�E.'4– -+"- Lo ation and legal description of lot to be built on: Lot Block 1Cx{ Subdivision to „ S tl ® ii -ic�3 $ tti� ' Street and Number where work is to be done "75 vQe. l0\ Si' . State work to be done and purpose of building (by floors) CPC; r2TDCk-q..4 CMC f"'‘ eCi- CSC 1 l hw.\L■t •9 I 1.) QLkle CC O - r<�1� t1.2(....LOS0 tt.0 , and for no other purpose. New Building ..--- Remodeling Addition t/ Repairs No. of Stories f To be constructed of eb Kind of foundation e4511'' 4 Roof Covering - CM- . "' 40hJ:� -- Estimated Total cost of improvements $ S O Amount of Permit S. .Plan Cubage Size of Building Lot Zone cubage required Distance to next nearest building S Maximum live load to be borne by each floor I hereby submit all the pans and specifications for said building. All notices with reference to the building and its construction may S0 Ace tot ST. Selves ; c . 1 4 be sent to Cw 4d`-1 k1/4'%.- G. t■C�1..4-e 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 hint in the work to be performed under this permit; and will post or cause to be posteu 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 ouch ::u contra ttors, on work to be performed under this permit, as are licensed by Miami Shores Village. pA. �J Remarks..._ (Signed). STATE OF FLORIDA, 1 COUNTY OF DADE. j SS. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgmen•s, personally ap- peared ____ 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. r. -a 6 Permit No .._._ . / _.: Date r� �'° _ Read, Sworn to and Subscribed before me. Disapproved f---•--- --....__..../ Date.__,-_: ___ ... ". �' ..,% �_ - .. .- Notary Public, State of Florida (Signed) ../ 2 -O Buildidgl'nspector My Commission Expires MIAMI SHORES VILLAGE Date... — .19.. PLANKING BOARD DATE Chairman Member Member Member Member ...... _...._..._._...__. --_ -.. Me:rmbor Council Approved Date Disapp.o° Date NOTE: A charge of $1.00 will be made for making correction:; or changes to this a;tp :icntion after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is mr.ro necessary by improper notice for inspection or faulty materials and /or workmanship.