47 NE 93 St (7)lUILDING
LECTRICAL
'LUMBING
><OOFING
,rchitect
:ontractor
r Builder
egal Lot
iescripti
ddress of
uilding
]caner of
juilding
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 3 215
Bl.
Work to be performed under this Permit
Subdi-
vision
Value cf
Project $
DATE
Contractor's
License No
195
Amount of
Peimit 8
This permit is granted to the contractor or builder named above to construct the building or .o install the equipment or d=_vice described in the application
crefor in strict compliance with all ordinances pertaining thereto and with the understandincr that the work will be performed in complianc:, with any plans,
awings, statements or specifications that may have been submitted to and approved by the pro, municipal authorities. Th.s Permit may to revoked at any
ne if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon wrtich this permit is
- anted is the understanding that the contactor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
;:rtaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications cnd that he assurnes responsibility for work
no by his agents, servorus or employees.
Signed._
INSPECTOR
In consideration cf the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
rta_ning thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper cuthoritics of Miami Sharks Village. In ac-
pting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
C ;ONTRACTOR OR BUILDER
BY
AUTEORITY
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BLHLDING 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.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor
Building Inspector
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to rue done and purpose of building (by floors) � d (' Y .._. .7i
Date 7e
No... ..7 Street
/«
Notary Public, State of Florida
,19
and for no other purpose.
New Building . Remodeling Addition__._ Repairs No. of Stories
To be constructed of.../.7712 -a Kind of foundatipn._.. li.' d■c.._. Roof Covering
Estimated Total cost of improvements $ 7 a Amount of Permit $
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 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 sucl s�l�contract9rs, or;' work to be performea under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed).
• y
STATE OF FLORIDA,
COUNTY OF DADE. f 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.
Disapproved Date
(Signed)
My Commission Expires
PLANNING BOARD DATE
Chainnan 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.