1200 NE 102 StMIAMI 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 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 a' building during progress of the work.
Date 1.2 /J NA � 7 ,�"
1 9 S1
Owner's Name and Address. _... q 6Q ..
k - EPFER No. ,t0 Street_. .E1 2 F
Registered Architect and /or Engineer �,�/_ 1'4 Vo o le _( _ E$ �
Name and address of licensed contractor SI T0 $ BROX.____ sr V 'e T/ 01V �--0 i i / O/ 0
Location and legal description of lot to be built on: on: A.
Lot d Block ! _5"" Subdivision AX 'BRE ESE S EC I0141
Street and Number where work is to be done / D ! E • / 61 2- ST I
State work to be done and purpose of building (by floors) . - V--' P 0 ° 1 t 1 ttU AS. T.7C .kT/ DAI
, E,4 t4
and for no other purpose.
New Building Remodeling. 1 Addition Repairs No. of Stories
To be constructed of.__. A P .. Kind of foundation P-C— Roof Covering__.Til^E
Estimated Total cost of improvements $ 5-00 �� e� Amount of Permit $ 2. , "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 su miit the plans a d specifications for said building. All notices with reference to the building and its construction may
be sent to 0 !` •oo? JTO
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, Pennanent 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 subcontractor on work to be performed der this
permit, as are licensed by Miami Shores Village. WOES r-0Q, r Grp' u (O-
Remarks (Signed) Pp
STATE OF FLORIDA,
COUNTY OF DADE. J ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, 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.
Permit No Z f 07 Date. __1 2. - Z - 5-- Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING 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 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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
MIAMI SHORES VILLAGE, FLORIDA
DATE (a 194.
PERMIT N? 5734
License /6 3p
cense No
Work to be performed under this Permit 4 —� 9
att ga4eVad
Address of / G`
Building at
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 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 changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above sumes the responsibility for a thorough know1e e of the ordinances and
regulations pertaining to/the work covered hereby whether shown on the pl c raw o s .in the statements specification
,,
sibility for work done by his agents, servants or employees.
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with p}l�rdinances and kg� na .1 -
pertaining thereto and in strict conformity with the'.plans, drawings, statements or specifications submitted to the proper authoritie of Miami Shores Village.
In accepting is permit I ssun ponsibility,for all w ork done by either myself my agent ervant or employee. ,. .
, 0
CONTRACTOR OR BUILDER
Subdi-
vision
Value of j / i
Project 77��
v
OD
Amt. of � 6
Permit
By
AUTHORITY
mes respon-
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.
a ��-°
Date - �_(f/ /
G / 19 �
Owner's Name and Address _`)4/4 '- e 1 A .,t- Az _ Street AL AV t 3177 Sfi
r
Registered Architect and /or Engineer �AiY* e _ s: 145. _.1/2 -i hie _____
Name and address of licensed contractor " ''J'8' le.r. dot ti€
Location Id l
ocation and legal escription of lot to be builton: 9 `
Lot Subdivision
/ ZPe, / t /2 .�
State work to be done and purpose of building (by floors) ____ fg fy f el
% . 'C)
Street and Number where work is to be done
New Building Remodeling Addition__
To be constructed of — __ —_____ Kind of foundation
Estimated Total cost of improvements $ ige y % ,Amount of Permit $
Zone cubage required L___!\ `/ 0 __Plan Cubage
__Size of Building Lot
Distance to next nearest building.
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 „/ °' #/ •I k 'A v- C' v f/f �• L. 44.0
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. e
Remarks (Signed) _�'.
STATE OF FLORIDA, 1
COUNTY OF DADE. j
Permit No
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date_ 76
Disapproved Date
(Signed)
Council Approved__— _____— ___Date Disapproved
and for no other purpose.
Repairs No. of Stories___�__
eojf
4/p/ t47
Before me, the undersigned authority, a notary public, duly authorized to a mister 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.
7t3
Read, Sworn to and Subscribed before me.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Notary Public, State of Florida
to me well known,
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.