375 NE 102 St (5)OWNER'S NAME P
PRESENT ADDRESS L
LICENSE NO. P
PHONE NO.
JOB LOCATION (ST. OR AVE.) L
LOT B
BLOCK S
SUBDIVISION
GENERAL CONTRACTOR A
ADDRESS P
PHONE NO. L
LICENSE NO.
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PERMIT FEE S et 4 • ' � ® N
BUILDER'S BOND I
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NEW CONSTRUCTION T
TYPE S
STORIES R
ROOF CONSTRUCTION I
I NTERIOR CONSTRUCTION
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
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INSPECTIONS D
DATE B
BY I
INSPECTIONS D
DATE B
BY
FOUNDATION R
ROOF
BEAMS & LINTELS P
POOL
FRAMING A
AIR COND.
FINAL C
CLEAN UP
SLAB
SLAB
SPECIALS PERMITS PERMIT NO. DATE FEE
TEMPORARY SERVICE $
SEPTIC TANK A1 £GO J (( 6P7ic_ - im...pc_ ffi 74 $
SEWER - $
SOLAR HEATER $
GAS $
e
INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY
ROUGHING
TUB & TOP OUT
SEWER
SEPTIC TANK
SOLAR HEATER
FIXTURES
GAS
CONTRACTOR L. ay.� \S Q.. � O C., L4 SIZ.. . PHONE
yy DATE q— l' c ® FEE $ IT 4_
PERMIT NO. - 0 p
NEW BLDG. y� 1 ALTERATION 1 ADDITION REPAIRS
SPECIAL PERMITS PERMIT NO. DATE FEE
TEMPORARY SERVICE $
H. W. HEATER CONN. $
RANGE CONN. $ MOTORS $
FIXTURES $
INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL P4IO..eJ 'l8 K. R1 /2 -21 - `0 kips... //4•1JC-o...aS_
6
8
IFK 'C & BUILD( INSPECTIONS
CONTRACTOR Jero rcS
PLUMBING PERMITS
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PERMIT NO. 7 3 1 DATE '7 '
NEW BLDG. 1 ALTERATION 1 ADDITION
APPROVAL TO POWER CO. FOR SERVICE DATE
& INSPECTIONS
PHONE /
FEE S 2 -Y' -
REPAIRS
BY
0
1
- A
INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY
ROUGHING
TUB & TOP OUT
SEWER
SEPTIC TANK
SOLAR HEATER
FIXTURES
GAS
CONTRACTOR L. ay.� \S Q.. � O C., L4 SIZ.. . PHONE
yy DATE q— l' c ® FEE $ IT 4_
PERMIT NO. - 0 p
NEW BLDG. y� 1 ALTERATION 1 ADDITION REPAIRS
SPECIAL PERMITS PERMIT NO. DATE FEE
TEMPORARY SERVICE $
H. W. HEATER CONN. $
RANGE CONN. $ MOTORS $
FIXTURES $
INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL P4IO..eJ 'l8 K. R1 /2 -21 - `0 kips... //4•1JC-o...aS_
6
8
IFK 'C & BUILD( INSPECTIONS
CONTRACTOR Jero rcS
PLUMBING PERMITS
, ,.., (_
PERMIT NO. 7 3 1 DATE '7 '
NEW BLDG. 1 ALTERATION 1 ADDITION
APPROVAL TO POWER CO. FOR SERVICE DATE
& INSPECTIONS
PHONE /
FEE S 2 -Y' -
REPAIRS
BY
0
1
- A
CONTRACTOR L. ay.� \S Q.. � O C., L4 SIZ.. . PHONE
yy DATE q— l' c ® FEE $ IT 4_
PERMIT NO. - 0 p
NEW BLDG. y� 1 ALTERATION 1 ADDITION REPAIRS
SPECIAL PERMITS PERMIT NO. DATE FEE
TEMPORARY SERVICE $
H. W. HEATER CONN. $
RANGE CONN. $ MOTORS $
FIXTURES $
INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL P4IO..eJ 'l8 K. R1 /2 -21 - `0 kips... //4•1JC-o...aS_
6
8
IFK 'C & BUILD( INSPECTIONS
CONTRACTOR Jero rcS
PLUMBING PERMITS
, ,.., (_
PERMIT NO. 7 3 1 DATE '7 '
NEW BLDG. 1 ALTERATION 1 ADDITION
APPROVAL TO POWER CO. FOR SERVICE DATE
& INSPECTIONS
PHONE /
FEE S 2 -Y' -
REPAIRS
BY
0
1
- A
INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL P4IO..eJ 'l8 K. R1 /2 -21 - `0 kips... //4•1JC-o...aS_
6
8
IFK 'C & BUILD( INSPECTIONS
CONTRACTOR Jero rcS
PLUMBING PERMITS
, ,.., (_
PERMIT NO. 7 3 1 DATE '7 '
NEW BLDG. 1 ALTERATION 1 ADDITION
APPROVAL TO POWER CO. FOR SERVICE DATE
& INSPECTIONS
PHONE /
FEE S 2 -Y' -
REPAIRS
BY
0
1
- A
6
8
IFK 'C & BUILD( INSPECTIONS
CONTRACTOR Jero rcS
PLUMBING PERMITS
, ,.., (_
PERMIT NO. 7 3 1 DATE '7 '
NEW BLDG. 1 ALTERATION 1 ADDITION
APPROVAL TO POWER CO. FOR SERVICE DATE
& INSPECTIONS
PHONE /
FEE S 2 -Y' -
REPAIRS
BY
0
1
- A
-
MI SHORES VILLAGE, FLA. No 1631
INSPECTION
TIME READY
REMARKS.
< P'
INSPECTOR
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DATE
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/MIAMI SHORES VILLAGE
04-‘. 6 �
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.
19 �
Date Z) _
Owner's Name and Address/ O'VA/ 11 C A eeb L C No 9■$ Street/II 447
Registered Architect and /or Engineer ", CSC
Name and address of licensed contractor S.f . 4.r7
Lon and legal description of lot to be built on:
LotoV s 42:27A5lock 3 Subdivision
Street and Number where work is to be done / `-r lV _ ... Q ..Z A Z —
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Ss -
To be constructed of. L 7 3S Kind of foundation G'o 4/ C
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required At t., 0 � _Plan Cubage 73.
Size of Building Lot
Distance to next nearest building.. __._
Remarks ( Signed )._
Disapproved
(Signed)
RooCovering
/a
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 performe under this permit; and will post or cause to be posted for insp:ctio-: on the site of the wor s ch public notice
or notices as are required by the Act. The undersigned agrees to employ only such subco- - , on wo to b ormed under this
permit, as are licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. 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 rue.
Permit No Date — [D _ a Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
'4
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.
16
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