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FENCEMIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ I-- Ar- ejcr' 19 Owner of Building Architect Contractor or Builder - 40 4-J Z PERMIT N° 5590 DATA'_ i Contractor's License No. Work to be performed under this Perini _ Legal Lot II / Description H 4 Z j a 13- Bl. � Q Address of 7 BuildingAl Subdi- vision �' .- err- . �_ f , t -ea Value of �� Amount of Project $- I 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 furthor copdition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowled6 of iffie.ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the s tements or specificgtions and t he usotimes responsibility for work done by his agents, servants or employees. f INSPECTOR In consideration of t#e issuance to me of this permit I agree to perform the work covererl'i iiereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications gOmitted 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. CONTRACTOR OR BUILDER BY AUTHORITY 6' MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is bereby made for the approtal 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. Date_..»]_L � --------- .__.._- .._.......... 19� Owner's Name and Address .......... 57 Registered Architect and/or Engineer------ ------------- -_---------------- -------- --- --- ---_-............ Name and address of licensed contractor ..... -!^?.? --� -• -- Locatioc. and legal de.=Iption of lot to be built on: Lath. ``� -�"°..j Block-........Z ............. Subdivision..... Street and Number where work is to be done-._•sQ. ..- .f......... � State work work to be done and purpose of building (by floors)__._.___..._,...._.___.....-- -------------- q-1-------------------- FEt L_<L_------------------- --------------- � for no other purpose. New Building ----------------------------- Rernodelin ------------ Addition -------------------------- Repairs -------------------------- No. of Stories ------ ._-----____________ Tobe constructed of ......................__... Kind of foundation ---------------------------------------------------------------- Roof Covering------•-------------- ------------- ------------ Estimated Total cost of improvements 4�0 ------Amount of Permit $..._....__.................---- _.__—__.._._. Zonecubage required --------------------------------- -...... ----.._--------- ....... ._.-......... PI -In Cubage............. _ _._. —____ ......---_----.---.____ _ ..... .. _. Distance to next nearest building ------------------------------------------------------------ Size of Building Lot_._... _ _ . _._.____._:.... .._...,........................ Maximum live load to be borne by each floor _........._. ... -............. _._............ .._...............-------- .......................... ...w__.._........... 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 be 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, Perinanent Supsplenient, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub -contractors eniployed by him in the work to be performs 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 ................ --- ....... ----_-- STATE OF FLORIDA, ! ss. COUNTY OF DADE. J 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 are true. Permit No --------------------------------------------- Date..-.-. ------------- _.____._ _••__-- Read, Sworn to and Subscribed before me. Disapproved -.......---------------- ------ -------- Date ------ .................... .. ............ Notary Public, State of Florida ( Signed) .. — _-._.......... .............. ........... _._--- . ----- __------ _...- Building Inspector ' My Commission Expires-____ — - - --------------------------- PLANNING BOARD ---------------------- ---------------------------------DATE Chairman----.-...---------.-Y �.__._ _..._..__� _ 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.