MECHANICAL PERMITBUILDING ❑
ELECTRICAL ❑
PLUMBING ❑
ROOFING ❑
PERMIT N° 4731
MIAMI SHORES VILLAGE. FLORIDA
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
Work to be performed under this Permit (
B1
DATE_ 195
Contractor's
License No. ; r
ubdi- r ,
vision
Value of
?roject $
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 and 3rstanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approve 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 clanged without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes th- responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or 1 the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees. /
Signed. ' 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 specifications 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 c gent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY �L�6
MIAMI SHORES VILLAGE E rg 66d'
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or ine plans and specifications herewith submitted for the build •
ins 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.
@.,/( � LAD Date..._..
.t:'1. .. ».__ .... »... ,19J
Owner's Name and Address .......E. °L .v 1 � ». No.� s . Street--q.3
1
Registered Architect and /or Engineer....... .
Name and address of licensed contractor .i.. . Etb,.).. i..a C IN
Location and legal c)cscription Jot to be built on:
Lot. ii d.,. .. .I/ rod . - .0 ock A »`� -'
1 Subdivision ..4 . 1/ _.... /,L_ 94...7
- , '` .7.,�.' .._ ---+
Street and Number where work is to be done it.�4_.._....ra __..C/ ...�Z. _.••.__
s4 ( %14i
Da�� to
rV
to woric to be done and ,pure se of building (by floors) X _
i® ... T cling v' . `;
"o
: d for no other purpose.
No. of Stories
Rci Covering
60,7 7F/repair
To be constructed of Kind of foundation.
/ J
79
Estimated Total cost of improvements S 4 •( . Amount of Permit S...
Zone cubage required .Plan Cubage
Distance .to next nearest building Size of Building Lot
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 permit does hereby certify that he understands and accepts his obligations as an t•nrpinyer
of labor under the Honda Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied kith 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 • , , e site of the work such ul lic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontra.. • s, o work to be • rf e • der this
pcnnit, as are licensed by Miami Shores Village. >
Remarks
(Signed).— ...... _ . .....
.�
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned thoritl, a notary public, duly a thorized to administer oaths and take acknowledgments, personally ap-
peared
Notary Public, State of Florida
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...2 10 9 Date Rea , Sworn to d Subscribed before me.
Disapproved
(Signed)
My Commission Expires....1 ,if,�;.,:,.. „
Building Inspector
PLANNING BOARD
flmrdcd aro Trcy Fain • Icsmncc, Inc.
' /8 /
_ ».. . ( i.
Chairman 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 Pl.rnnir.;; 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.