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PAINT PERMITUILDING rLECTRICAL LUMBING - OOFING honer of uilding rchitect : ontractor r Builder egal )escription .ddress of uilding 1/ { El ❑ DATE 1c- -' 195 c ❑ PERMIT N? 4 414 Contractor's License No. i 2 ` © Work to be performed under this Permit MIAMI SHORES VILLAGE. FLORIDA • Ti r ./ Lot In consideration of the issuance to me ertaining thereto and in strict conformity with opting this permit I assume responsibility for CONTRAR OR BUILD S� t .1 Subdi- vision Value of Project $ /t - j► Amount of Permit $ This permit is granted to the c'oniractor or builder named above to construe the building or to install the equipment or device described in the application erefor in strict compliance with all ardinanco6 pertaining thereto and with the understanding that the work will be performed in compliance with any plans, rawings, statements pr specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any me if 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 ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations ertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specific .• iblis and that he assumes responsibility for work one by his agents, servants or employees. Signed. INSPECTOR of this permit I agree to perform the work covered he. under 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 (Signed) 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 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. 19 Owner's Name and Addre Z� No. \\S Street / L/ Registered Architect and /or Engineer / v Name and address of licensed contractor Le /2 " i ie../ Location and legal description of lot to be built on: �% VOA--e Lot 7 Block S // 1° as '1,54. c / Q �c l reet and Number where work is to be done " - `r mot✓ Ck'D--- � - �r fi8t. le work to be done and purpose of building (by floors), state exterior colors (submit samples) Z— 1 ``4A■■:; and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering t/Estimated Total cost of Zone cubage required Distance to next nearest Maximum live load to be I hereby submit all p MIAMI SHORES VILLAGE 26 ‘7,73--- BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Peppermint Pink 17 - 19P c 2XD . � _Amount of Permit S Remarks (Signed) Permit No. c217// 9 Date Disapproved Date Date \ W Plan Cubage Size of Building Lot 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 obligatons 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 undersigne ees to employ only such subcontractors. on work to be performed under this permit. as are licensed by Miami Shores Village. STATE OF FLORIDA COUNTY OF DADE. ) 55. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared 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. Read, Sworn to and Subscribed before me. Notary Public, State of Florida to me well known. Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of S25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.