102 NE 102 St (4)MIAMI SHORES VILLAGE, FLORIDA
BUILDING
ELECTRICAL
PLUMBING
Owner
Buildin
Architect
Contractor Ote,-it.a or Builder
Legal • Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
DATE. 1947
PERMIT N? 5 6 0'7 Contractor's
License No
Work to be performed under this Permi 0414€'
•
Bl.
Subdi-
vision
Value of
Project
This permit is granted to 0 e contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 ged out thori 'on. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above ass the r• .nsibil'17for 4or rough knowledg• • fiances and
regulations pertaining to the work covered hereby whether shown on the plan fications and es respon-
•
/
sibility for work done by his agents, servants or employees. /
•
Signed: � z , -- By
i.W - OR
In consideration of the issuance to me of this permit I agree to perform the toor overe ereunder compliance with all ordinances and Leolations
pertaining thereto and in strict conformity with the plans, drawings, statements or specificati submitted to the proper adfi rities of Miami 3/illage.
In accepting this permit I assume responsibility for all work done by either myself, my agent, ervant or employee. •
BY
J V
ci....,
Amt. o
Permit - f
AUTHORITY
MIAMI SHORES GE
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. "�,,^
j i, 6, c r` ' . 4 .G',
Date_ —_., , —�� r , 19__ _
E,/ -- No / __ ___ Street__ 'i d 1
7
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor u� .
Location and legal description of lot to be built on:
Lot Block � Subdivision � /�j ✓ }
Street and Number where work is to be done , /
State work to be done and purpose of buil 'ng (by floors) _R✓ " j' ��'�`rf°" '/(71
' l fs 4'6 . ° , '¢- . ' ' M c ',, Q i _e :. ' is _�`, /;
/y
e ' __4 and for no other purpose.
New Building___________________ Remodeling______________ Addition Repairs No. of Stories________________
To be constructed of_____--_______ Kind of . o ndation,_ _ R Covering__
Estimated Total cost of improvements $ ______Amount of Permit 5_ -_.-
Zone cubage required
Distance to next nearest buil ding_ _______________________________ —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 aubconttactors, on wo to be performed under this
permit, as are licensed by Miami Shores Village. G � / c
Remarks (Signed) �
�.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
0
appeared
Building Inspector
_Plan Cubage
My Commission Expires_
Notary Public, State of Florida
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved_ Date Disapproved
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 constructjon -that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him s9t0 are, true.
r r
Permit No. Date___ Read, Sworn to and Subscribed before me.
Disapproved — _— _— ______ Date
(Signed)
_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.
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.