568 NE 102 St (2)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build-
ing cr other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and ail provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Buildirg '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.
Q Date q- a 2' -. , 19
Owner's Name and Address. - ...... _ \� 1l � , ° - - No Street
it4e;;'>:tared Architect and!or Engineer
Nrx!e, and address ei licensed contractor____ ._
.ocaiion and legal description of lot to be built on:
Lot -._ -_- -_ -- -' Block 9. Subdivision
Streit and Number where work is to be done 6 n- - t 0
State work to be done and purpose of building (by floors)
P
and for no other purpose.
New Building _ temodeling Addition Repairs No. o_ Storjes e
flemarks
To be constructed of_. Kind of foundation � .1� Ay✓ Roof
Estimated Total cost of improvements $ 7 is Amount of Permit $
/4 5 i ' e �� 2,
one cubage required flan Cub >
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
hereby suomit 211 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
i 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
cr no ices as are required by the Act. The undersigned agrees to employ only such subcontract n work to be performed under this
permit, as are licensed by Miami Shores Village.
(Signed) ��(( fm 4/ < /7
STATE OF FLORIDA, p
COUNTY OF DADE. 9
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 t at he is the_
of the above described construction, that he has carefully read the fo egoing application, and that he did sign the same, and that all facts
th.yain by him st ted e true.
Permit No G _ _ Date '/ / eir Read, Sworn to and Subscribed before me.
Dic2ngeoved d 4 Date
(Signed) wocirmah
' I llif qi s '.ectoia My Commission Expires
,h: i ?man
Mcinbc
ngc���iJ:.r
Notary Public, State of Florida
• PLANNING BOARD DATE
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 Po-ud.
A re- incpc:c ti-in fee of Si.; 0 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
_> ,1s enci /or workmanship.
„
•
”
- 77
• ,
Permit No.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 m 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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work. c LL
Owner's Name and Address. __.. _ ._ No._._ .......... .. ._ Street
Registered Architect and /or Engineer .__,
Employing Plumber's Name 6 AS6- 143 `�' ' .- - -. -__ No._
Location and Legal Description Lot .__.
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors ) _
R� modelin)_ Addition_.
New Building
Nature of Water Supply: City —Well
Amount of Permit $.
B1oc
pit 11! �0 Street.
_._.. of Soakage Pit
(Signed)- — -- -
_- Repairs.
Date /
Street__
Subdivision
Size Septic Tank_. _ -- So ® ..Type of Tank_ _... ____.. _------ __ - -..
Feet of Drain Tile ..... .. clo t d6 Dist. Feet of Tank or Drain Field from Well
Capacity Gals
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga•ions as al, employer of labor
under the Florida Workmen s Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied 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 sub - contractors, on work to be performed under this perniit, as are
licensed by Miami Shores Village.
No. of Stories
Plumbing Inspector.
Master Plumber.
STATE OF FLORIDA, ( ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .,ppeare
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 i.u•
therein by him stated are true.
My - . remission Expires Notary Public, State of Florida
NOTE: Are spection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Ltd
materials and /o orkmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
u
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRIIIK INS
FOU NT 045
--
TOTAL
FI[TUR[I
/
/
/
'�• —
CONTR.
LIST
CHICK
i 00
-
9 g !!
9
fff
SWIM 0
POOL
Dyfiig-
W � �i�P - i �
SEPTIC.
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
CONTR.
LIST
CHECK
/
/
/
�
^ f /
,,,qs-
/ ®
/ ®O
Permit No.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 m 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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work. c LL
Owner's Name and Address. __.. _ ._ No._._ .......... .. ._ Street
Registered Architect and /or Engineer .__,
Employing Plumber's Name 6 AS6- 143 `�' ' .- - -. -__ No._
Location and Legal Description Lot .__.
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors ) _
R� modelin)_ Addition_.
New Building
Nature of Water Supply: City —Well
Amount of Permit $.
B1oc
pit 11! �0 Street.
_._.. of Soakage Pit
(Signed)- — -- -
_- Repairs.
Date /
Street__
Subdivision
Size Septic Tank_. _ -- So ® ..Type of Tank_ _... ____.. _------ __ - -..
Feet of Drain Tile ..... .. clo t d6 Dist. Feet of Tank or Drain Field from Well
Capacity Gals
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga•ions as al, employer of labor
under the Florida Workmen s Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied 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 sub - contractors, on work to be performed under this perniit, as are
licensed by Miami Shores Village.
No. of Stories
Plumbing Inspector.
Master Plumber.
STATE OF FLORIDA, ( ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .,ppeare
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 i.u•
therein by him stated are true.
My - . remission Expires Notary Public, State of Florida
NOTE: Are spection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Ltd
materials and /o orkmanship.
(A copy of this Application, together with one copy of plans and specifications, must be kept at building during
progress of the work)
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub-
mitted for the building or other structure herein described. This application is made in compliance and conformity
with the Building Ordinance of the City of Miami, Florida, which'said Ordinance was proved July 7th, 1919. All
provisions of the Laws of the State of Florida, all ordinances of the City of Mi • , nd all les at;td regulations
of the Building Department of the City of Miami, shall be complied with, wheth rein, fitsi or arot.
CITY OF MIAMI
FLORIDA
( )
OFFICE OF BUILDING INSPECTOR
APPLICATION FOR BUILDING PERMIT
Date
Owner's Name and - at1dres0 7 f // ` t /'� Street
Architect
Name and address of contractor or builder ,f #1 €�
Location and legal description of lot to be built on:
Lot ' Block Subdivision / r :'' " /�
Street and Number where work is to be done ( ,./ /( ° 74 -4 7" ,
Purpose of building (by floors) &'d't k � ` �`'' ^�� /I .1 -- ) v g`
eta i
] and for no other purpose.
New Building < e f ` v Addition Repair '1
Remodeling Number of Stories
Estimated cost of , Improvements (not including furnishings) $ ' _"', �'� e�
Type of Construe ' n ■ ` " .f (A(I.` A.
Roof covering
-�1� r '" � �- " a , (..-2-',I' F'2-•:
I Foundatio:
Number of persons to be accommodated (maximum) per floor W40(
Size of building lot— ` � ' � i z ti .. Distance from next nearest adjoining building (from all sides except
street) ;%'° 1 ''
Heating system, if any (kind) -'/' t''' t° Plumbing ?,' Elec ,! i z „
Elevators: passenger `r� ' freight Manufacturer
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 iv j ,.
STATE OF FLORIDA,
COUNTY OF DADE. } SS.
Before me, the undersigned authority . notary pu . ic, duly - authorized to administer oaths and take acknowl-
edgments, personally appeares " _ :�41.f -- .
( „1
t. w
—
(Signed)
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 building, 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.
Read, sworn to and subscribed before me, e'')
Notary Public.
My commission expires
THIS TO BE FILLED IN BY BUILDING I SEECTOR
Permit No ) $- -,: issued upon above Application / ��' ,
Classification
Disapproved , 192
Reasons:
In this space give lot dimensions; make sketch of
ground plan, and distance of building from all lot lines.
t
f
`
, 192
No
(Signed)
Building Inspector.