410 NE 102 St (12)MIAMI 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 at building during progress of the work.
�'1.. Date June 28th
Owner's Name and Address..ROb.ert...A.....Dal k. No 41 Q Street_ 02nd .5,
Registered Architect and /or Engineer
Name and address of licensed contractorLang- ._Af_g.0__.L•_TilE___L12-..1x10._._. -3- ..1. St ,• Miami 1 0
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 41Q N, E. 102nd Street
State work to be done and purpose of building (by floors )Tear Of f e ting ro 0 f , a .•• 1730# felt,
mop._.1- 90.#_. -slate with & cover with white cement barrel tile, mop
2 -1,# felts over 30# on gravel deck & cover v4.th pea - gravel & g a e prit - .
an or no of r purpose.
New Building Remodeling Addition Repairs'Re —r 00 f No. of Stories 1
To be constructed of Kind of foundation Roof CoveringC.4'.ffl.L.'.lt tile & Gravel
Estimated Total cost of improvements $ 1 995..00 Amount of Permit 7
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 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 pennit 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 Sup dement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or s contractors employe by him
in the work to be performed under this permit; and will post or cause to be posted for inspe on on th f the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subco o wo to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks 232sgs
(Signed)
STATE OF FLORIDA, k
COUNTY OF DADE. ss.
peared
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
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._1! ' 7 Date___L..IA2`2 /7 Z. Read, Sworn to and Subscribed before me.
Disapproved Date. ___.________________
(Signed) __c.,, �.___� ; � ceL LC` g _ Notary Public, State of Florida
Building In ector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A cliarge 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Legal Lot
Description
Address of
Building
❑ PERMIT
CONTRACTCR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Architect
Contractor -
or Builder -7. ,
N? 5286
Work to be performed under this Permit
/
II Bl
Value of
Project
INSPECTOR
/2
DATE ° 195
Contractor's /' f , j
License No. .
Subdi-
vision
Amount of V
Permit $ ••"
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 application
herefor in strict compliance with all ordinances pertaining thereto and with 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 assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that heeessumes responsibility for work
done by his agents, servants or employees. / I?
r � �/ j Y g ar ` .
Signed � ` � Y , " / , /. Y t A' r BY ,e, .-
v' r
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Owner's Name and Address.
Registered Architect and /or Engineer
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI 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.
Name and address of licensed contract()
Location and legal description of lot to be built on:
Lot Block Subdivision.
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
Disapproved Date
(Signed)
Date
NO-40 4 ' Street- % 4 f • 4d
Notary Public, State of Florida
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
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 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 pennit 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.
Remarks ( Signed)
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 const uction, that he has carefully read the regoing application, and that he did sign the same, and that all facts
therein by ted
Permit No.._, _ Date Read, Sworn to and Subscribed before me.
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.
MIAMI SHORE VILLAGE
. BUILDING INSPEC IO If DEPARTMENT
APPLICATION FOR PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the b
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi
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.
z•
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor Self
Location and legal description of lot to be built on:
/. Block Subdivision
eet and Number where work is to be done 410 N.E. 102 St,____
State work to be done and purpose of building (by floors).
Roof and screen present open porch
- - - -- and for no other purpose.
New Building Remodeling X
To be constructed of Kind of foundation Roof v&ing __ Tile
Estimated Total cost of improvements $____3_40,_00 Amount of Permit $ "� O
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 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 sit- of the work such .ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such . ntracjors, on w to be pe forme under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned autho • , a notary public, duly auth r' ed to administer a take acknowledgments, personally ap-
peared
Willis'm Goldstaub
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
thereinshy him 'stated 'are true.
Permit No - Date
Disapproved Date
Date Se_p.t_._ 2E4 ,194$__
No. 410 Street
Addition Repairs No. of Stories
- ,, and Subscribed befo
�' Not. Public, State o ... d
Building Inspector My Commission Expires__My__cmnmiiien exg rc3 _A ery "5` IS"
® Boi dl by Aran ire3sj �
� P�'NNING BO D C r l / �� �
�j� 1�_t�ATE
Chairman - - /I/ i 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.