DRIVEWAY PERMITBUILDING ❑
ELECTRICAL ❑ DATE 195
PLUMBING ❑ PERMIT N? 6 0 95 Contractor's G
License No.
ROOTING ❑
Bu ilding kr Le. 0 a6/
Architect
Contractor _
or Builder LL e
Legal Lot
Description
MIAMI SHORES VILLAGE. FLORIDA V
Address of o p
Building ei e
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 it 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 thorougiknowledgf ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings cr in the satements or specifications and the he assumes responsibility for work
done by his agents, servants or employees.
CONTRACTOR OR BUILDER
Work to be performed under this Permit
Bl.
Signed
Value of
Project
BY
u
Subdi'
vision
$
11 Amount of
11 Permit $
AUTHORITY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covereObereunder in compliance with all ordihcmces and regulations
pertaining thereto and in strict conformity with the plans, drcrwings, statements or 'specifications submideCI to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, my elf, y agent, servant di employee.
BUILDING ❑
ELECTRICAL ❑
PLUMBING ❑
ROOFING ❑
Owner of
Building 1/, V
MIAMI SHORES VILLAGE. FLORIDA
PERMIT 11T° 4685
Architect
Contractor
or Builder gr i •
Legal Lot
Description Bl
Address of -
Building
DATF ,r '
Contractor's
License No
195.Y
Work to be performed under this Permit
Subdi-
vision
Value of
Project $
This permit is granted to the contractor or builder named above to construc 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 municiprfl' 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 authorizd A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a through knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drags or in statements or speoilications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed. 4
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 specificati9fis 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.
t `
, t 7 . ;, ,v.i .
CONTRACTOR OR BUILDER
BY
Amount of
II Permit $
44
AUTHORITY a
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 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 regula-
tions 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
Owner's Name and Address dJ1 �' -i' / P.! _ No.
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
__ Block_ _ - Subdivision
Street and Number where work is to be done
State work to be done an purpose of building (by floors) _
9o� -a0—,_
` fereby :u.mit a t
be sent to
Remarks
STATE OF FLORIDA,
COUNTY OF DADE. f
and who, being by me first du
of the above described const
therein by him stated are tru
Permit No
Disappro
(Signed) _____
MIAMI S I-L.O RES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Addition
Atadt
(Signed)
New Building ____________________________ Remodeling
To be constructed of _____W___ Kind foundation �� Kopf Covering
Estimated Total cost of improvements $_�__� __ Amount of Permit $.2 {�
Zone cubage required__ Plan Cubage__ _________
Distance to next nearest building_______ - ___ _—__ _ _ Size of Building Lot
Repairs No. of Stories__
Read, Sworn to and Subscribed before me.
L
and for o other purpose.
and specifications for said building. All notices with refer . ce to t . - building and its construction may
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, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from cont actors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted f. tnsp cti•n on a site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such bcont a o work to be performed under this
permit, as are licensed by Miami Shores Village. r
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known,
upon oath deposes and says that he is the
carefully read the foregoing appliion, and that he did sign the same, and that all facts
Notary Public, State of Florida
Building Inspector My Commission ______
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved_______ Date Disapproved
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-i . : \ tion is made necessary by imp er nottc for inspection or faulty
materials and /or workmanship.