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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.