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47 NE 93 St (9)BUILDING ELECTRICAL 17 :PLUMBING n ROOFING 3 of 3uilding Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA PERMIT NY 4124 Work to be performed under this PermA Subdi- Bi. visor S ign e d: DATE tl:ontractor's 'jean se No. Value of Ai ci Project $ . Permit $ This permit is granted to the contractor or builder named above to construct the building or to install th _guipment or device tion herefor ir strict compliance with all ordinances pertaining thereto and with the urden..tanding that the wo-k will be performed ii 1.1•111' PIEMS, drawings, statements or specifications that may have been submitted to and approved ay :lie proper municipal arthoritie., Thi Pe • nit at any time if the work is not done in compliance with such ordinances or if the plans are changed withal': authorization. A further candiiinn permit is grarted is the uncerstanding that the contractor or builder lamed above assumes the reoponsibiiity for -. thorough knowledge of th, rcgutaEons pertaining to the work covered hereby whether shown on the plans or drawing; or in the statement. or filecifications and tiat tibility for work done by hi agents, servants or employees. ri in the aaplica- :Hance with any rnav he r,. yoked upon which this ordinances and assumes tr INSrL TO La cork-Adoration of the issuance to me of this permit I agree to perform the work covered hereunder in cc:Tip with aJ c: : and regulation pertaining thereto and in strict conformity with the plans, drawings, stc:.ements or specifications submitted to the rror.sr crathorities of Miami Ehirs Vinage. In ea coating this permit I assume responsibility for all work done by either, myself, my agent, E7avant or ompleyee. CONTRACTOR OR BUILDER BY AUTHO NO se AM ' a 0 'ES V LLAGE DEPARTMENT 8LLANG PERMOT UILDOO G ONSPECTIIO Application is hereby made for the approval of the detailed statement of the p:.ans 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. /6 , 190 /� Date Owner's Name and Address _C r ( ( p y? - Registered Architect and /or Engineer ... _ Name and address of licensed contractor._ Location and regal description of lot to be built on: Lot Block. Subdivision Street and Number where work is to be done V7 W f_ State work to be done and purpose of building (by floors)__(- �t No.Y7 "YZ Street ... ._ and for no other purpose. New Building Remodeling Addition t,----- Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ .__Amount of Permit $ 3 a 6; �� 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 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 pblic 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. Remarks (Signed) I A � - 1_. _ . _ elf . STATE OF FLORIDA °.� il� -7..„, 1 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 I Date. j IA - 6 $ Read, Sworn to and Subscribed before me. Disapproved _ D (Signed) - --- - - - -- � i c � ` Notary Public, State of Flarida -- - 4.Z? = B i ing I Spector 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.