541 NE 102 St (9)tl''" d s MIAMI SHORES VILLAGE
6 4 tAr % l7
APPLICATION FOR BUILDING PERMIT
Registered Architect and /or I;,nsincer
Application is hereby made for the approval of the detailed statement in 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 he in specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
&/ Da te... v
Owner's Name and Address � . :.. _ No.:.l / fd..Str �.
STATE OF FLORIDA, ! .
COUNTY OF DADE. ss.
BUILDING INSPECTION DEPARTMENT
Name and address of licensed contractor...
Location and legal description of lot to be built o •.
Lot Block Subdivision
Street and Number where work is to be done _..._._ .
State work to done an of building (by fl
Disapproved Z?��....�.L r Date
(Signed)
Building Inspector
New Building Rcrnodcling Addition Aepairt. tries. _
To 'be constructed of Kind of foundatiQp Roof Cov Ong
Estimate Total cost of improvements $ 5 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 labur under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo ida, Permanent Sup rlemrent,
anti has complied with the provisions thereof, and will require similar compliance from all contractors or sub- ntractors employe by hint
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site o the work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such subFor�ractors, , •n )etork be rformed under this
pennit, 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,
Notary Public, State of Florida
My Commission Expires _
65 9 2
er purpose.
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.. (:),,i+.519 Date (0 1 11 E-3 Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
Chairman Member
Member Member
Member .. .. Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Plannir.g Board.
A re•in\p(ction fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
4:
APPLICATION
Application is hereby made for the approval.of the plans and
specifications herewith submitted for the building or other
structure herein described. This application is made in comp-
liance and conformation with the Building Ordinance of the
Miami Shores Village, Florida, and all provisions of the Laws
of t e State of Florida, all Ordinances of Miami Shores Village,
and all rules and regulations of the building Department of
Miami Shores V'llage, shall be complied 'with, whetherspecified
or not.
OWNER
ARCHITECT 4 41.A/4// / / 4 ,7 fOR
LOT/ BLK 7. SUBDIVISION STREET ## J'/ lr( /o,2 —
NEW X ADDITION REPAIRS NUMBER OF STORIES / ROOF 7.
COST(excluding Architect's fee, Landscaping and Garage$ ,a�oo C7ico
Building to be used for rokr and no other use.
I hereby submit all the plans and specifica
building.
STATE OF FLORIDA)
COUNTY OF DADE )
Before,me, the and
duly authorized to admi
personally appeared
known, and who, being
My Commission expires
Chairm
Memb
Member
Secretary
Building Inspector
Prrmit No, j /,� Issued
Permit Plumbing No,
B:Li DLNG_ PERMIT - RECORD
MIAMI SHORES VILLAGE
FLORIDA
Planning Board
to
Permit Electrical No.
Signed �/
, .
osee
ons for said
•
signed authority, a notary public;
ister o thaxl d take acknowledgment,
o �// • to me well
n �y me firlt duly sworn, upon oath deposes
and says that he is the builderof the.above described const
ruction, that he has carefully *ead the foregoing application,
and that he did sign the same, OA that facts stated by him
are true. Read, Sworn to and Subscribed before me,
Notary Public (Signed)
Cubic Feet 17 I7 ' Cubic feat required in this Block ji \ D
7
Data %,,'
BUILDING ❑
ELECTRICAL ❑ PERMIT N?
PLUMBING ❑
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot II BI.
Description
Address of
Building « ;
15352
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER.
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
Value of
Project $
DATE 195
Contractor's
License No
Amt. of
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 he assumes responsibility for work
done by his agents, servants or employees.
Signed • BY
INSPECTOR
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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
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 oilier structure herein described. This application is made in compliance and conform ty w;th the Building Ordinance of Miami
Shores Village, Fior:da, and all provisions of the Laws cf the State of Flurid.'. all o d nances ;,f Mi .. Shores Village and all rules and
regulations of the Building Divi:,inn of ?tiami Shore_, Village •1` 1 '.e o .ipl:ed with, whether herein specified or not. A copy 01 approved
plans and specificatii ms must be key; at building durin . progress of tl.e °" i work.
Date . - - _..
Owner's Name and Address____ &• No._,_ Street_
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot
Street and Number where work is to be done_ ..4
State wo o be done and purpose of building (by floors)
Remarks__
New Building
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Block___ ___.. Subdivision
E 10 I/,-
(Signed )
and for no other purpose.
Remodeling Addition _.. Repairs.. - ' ., No. of Stories_ .
To be constructed of_ Kind of foundation________ _____.. Roof ov:'ring.
Estimated 1 - :,tal cost of improvements $__... d0 Amount of Permit $__ . /i_ „
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 5968, Coii pled Gen. •a1.L-aws of Florida, Pernianen: 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 subcontr. ctors, on work to be performed .order this
permit, as are licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths i.nd take acknowledgments, personally ap-
peared
and who, bein .y me firs my sworn, upon . deposes and says that a is the _.
of th - above • d .cribed ction. that he refull ; read the for oing application, and that he did sign the same, and that all facts
therein by him ated ar
Permit No _______
_.__
Disappr ed
( Signed -
Bui ding In My Com:nission Expires_
d, Sworn to and Subscribed before me.
Notary Public State of Florida
PLAN G BOARD DATE
Chairm Member _ --•_ ---- -- -...
Member Member
Member ._ ..__ .. Member
Council Approved. -Date Disapproved
19.3
�. /4o A
.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 inspecton or fay.Ity
materials and /or workmanship.