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MECHANICAL PERMITBUILDING ELECTRICAL PLUMBING ROOF ING L 34 Owner of Building 1 Architect Contractor C . IC or Builder Legal Lot Description Bl Address of Building 1 ' In consideration of the issuance to me pertaining thereto and in strict conformity with cepting this permit I assume responsibility for CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA PERMIT N° 6749 r-- Work to be performed wider this Permit Signed DATE. Contractor's License No 195 Subdi- vision Value of — Project $ 7 Amount 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,ther condition upon which this "perictiris granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough Knowled of the ordinances "and regulations pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. i f l / INSPECTOR /` of this permit I agree to perform the work covQied hereunder in compliance with all ordinances and regulations the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac• all work done by either, myself, my agent, servant or employee. BY AUTHORITY APPLICATION FOR BUILDING PERMIT MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Application is hereby made for the approval 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. n Date Owner's Name and Address.. N��l.29. e Street Registered Architect and /or Engineer N 1 --in-e ame and address of licensed contractor �t"" Location and legal description of lot to be built on: Lot Block /1 Subdivision Street and Number where work is to be done /1 z 9' £ State work to bed a and purpose of building (by floors) ea.t., Disapproved Date.. J (Signed) Chairnan Member Member Building Inspec .r 2 1— 2 and for no other purpose. New Building Remodeling. Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ 2_9 019 Amount of Permit $ Zone cubage required .Plan Cubage Size of Building Lot Distance to next nearest building 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 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 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ��' C_ Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss 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 & c(2 Date z - Z — S� Read, Sworn to and Subscribed before me. Notary Public, State of Florida y Commission Expires LANNING 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 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.