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BUILDING PERMITBUILDING ELECTRICAL PLUMBING ROOFING Owner of Building /f Architect Contractor or Builder • r Legal Lot Description Address of Building MIAMI SHORES VILLAGE. FLORIDA © • ❑ it 1951,_ PERMIT N° L ❑ R ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER p r.L Bl 1 t Value of Project $ Subdi- vision 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 further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations Pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work - lone 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 -, ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- = epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY • MIAMI SHORES VILLAGE `' BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT 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. ``/ Date u et I ,, , 19._0.6 Owner's Name and Address ._..._- .._ i .LYJAI f P . Li. _ _. t //Ve No. _' Street_- _�1_CiA.M4.t_ I&.._.. Registered Architect and /or Engineer....&I.t &ar .17. '.mid._ 4/2Lh:f.T6'Cr • 4 . Ll ' recii. mhi... Emp14.6,4g Name and address of licensed contractor 4 A /14 f• icEgt.L_....__ '' . 1 Vic-ms K'-'A.._.. 14-d , Location and legal description of lot to be built on: Lot c A Block Subdivision 64V h.[.l1 . Street and Number where work is to be done 11 Al . Itli ___3. State / work to be done and purpose of building (by floors) r_ .-Q /2-1 ! ;, !- ! �- - -• - - -d:,-61-. g 4 0. New Building V Remodeling To be constructed of a e6 S Kind of foundation __ - - ediviersi Estimated Total cost of improvements $__ 6Ce.,._J) Amoubt of Permit $ Zone cubage requ red.__ i s.Q a plan Cubage Distance to next nearest building__._ Q Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications /or said building. be sent to t'.d�' .___eihree / • Disapproved Date (Signed) Building Inspector Addition Repairs fie° / ,41 5 1 All notices with reference Roof _Covering Notary Public, State of Florida and for no other purpose. No. of Stories Y� to the building and its construction may The undersigned applicant for this building permit 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 inspec on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subco acto , on work to be performed under this permit, as are licensed by Miami Shores Village. 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 Date Read, Sworn to and Subscribed before me. My Commission Expires PLANNING BOARD DATE 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 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. ;fir \N! r-c: 5 ;_; Ve r ,h a , C. 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