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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.