525 NE 93 St (2)Size Septic Tank
Feet of Drain Tile
Permit No.
Amount of Permit $
Ss.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name d
Location and Legal Description Lot ____::.
Nature of Water Supply: City —Well.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 work.
t .
Block
No
No
Type of Tank C''
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)
4
_ (Signed)
Repairs
Date
/2
,l
Capacity Gals
Street-- - /
Street •
Subdivision
40 i
Street and Number where work is to be performed —No. Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
No. of Stories
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he Yinderstands 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 com-
plied 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 such sub - contractors, on work to be performed under this;' permit, -ras are,
O ✓ ,
.
licensed by Miami Shores Village. , - o ft ; - � ,
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fa'
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY'
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT 'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL.
CONTR.
LIST
S
CHECK
Size Septic Tank
Feet of Drain Tile
Permit No.
Amount of Permit $
Ss.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name d
Location and Legal Description Lot ____::.
Nature of Water Supply: City —Well.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 work.
t .
Block
No
No
Type of Tank C''
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)
4
_ (Signed)
Repairs
Date
/2
,l
Capacity Gals
Street-- - /
Street •
Subdivision
40 i
Street and Number where work is to be performed —No. Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
No. of Stories
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he Yinderstands 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 com-
plied 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 such sub - contractors, on work to be performed under this;' permit, -ras are,
O ✓ ,
.
licensed by Miami Shores Village. , - o ft ; - � ,
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fa'
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Owner's Name and Address ______'_____ _
Registered Architect and /or Engineer
Employing Plumber's Name
APPLICATION FOR PLUMBING PERMIT
Permit - - -- – – / Date — - -- _- ._r
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 work.
Street and Number where work is to be performed —No. ..f
New Building _ Remodeling
No
No . - -----
-
Street =
_____ -• _- _ __•__ -_' •
•
Location and Legal Description Lot_ I _ " °' Subdivision__
State work to be performed and purpose of building (By Floors) ______________.___�_
Addition Repairs No. of Stories
Capacity Gals
Size Septic Tank____ _____________________________ Type of Tank
Feet of Drain Tile____— _— _______ —___. _ _ Dist. Feet of Tank or Drain Field from Well ____________________________
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
(Signed)
(Signed) •
Street
Notary Public. State of Florida
•
S t r e e t _ _ _ _ _ _ _ _ _ _ _ _ . v
. • Plumbing •Inspector.
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 com-
plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to mister oaths and take acknowledgments, personally
appeared _
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
-
.. •
"
�.
TOTAL
FIXTURES
CONTR.
LIST
...
..
.�
...
....
...
_-.
.,
CHECK
v -
C
C
i i
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
- -
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Owner's Name and Address ______'_____ _
Registered Architect and /or Engineer
Employing Plumber's Name
APPLICATION FOR PLUMBING PERMIT
Permit - - -- – – / Date — - -- _- ._r
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 work.
Street and Number where work is to be performed —No. ..f
New Building _ Remodeling
No
No . - -----
-
Street =
_____ -• _- _ __•__ -_' •
•
Location and Legal Description Lot_ I _ " °' Subdivision__
State work to be performed and purpose of building (By Floors) ______________.___�_
Addition Repairs No. of Stories
Capacity Gals
Size Septic Tank____ _____________________________ Type of Tank
Feet of Drain Tile____— _— _______ —___. _ _ Dist. Feet of Tank or Drain Field from Well ____________________________
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
(Signed)
(Signed) •
Street
Notary Public. State of Florida
•
S t r e e t _ _ _ _ _ _ _ _ _ _ _ _ . v
. • Plumbing •Inspector.
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 com-
plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to mister oaths and take acknowledgments, personally
appeared _
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
1
ifs,f 1_ 1Y/
. ..e;‹
4 k,
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 10525
CONTRACTOR OR BUILDER
Work to be performed under this Permit—
Bl.
Subdi-
vision
Value of
Project $
DATE 195
Contractor's
License No
Amt. 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
done by his agents, servants or employees.
Signed • BY
INSPPCTOR
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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
BUILDING [-]
ELECTRICAL
PLUMBING [
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
11
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 11245
Work to be performed under this Permit
BI.
Subdi-
vision
DATE / _ 1 1951. —
Contractor s
License No
Value of Amt. of
; ' a Project $ 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
done by his agents, servants or employees.
Signed: ri. BY , Y
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 stria conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit t. assume responsibility for all work done by either, myself, my agent, servant or employee.
C�RACTOR OR BUILDER
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building_
Architect
Contracto
or Builder
Legal
Descriptic
Address
Building
MIAMI SHORES VILLAGE, FLORIDA
1
PERMIT N° 10841
Work to be performed under this Permit_
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device descried 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 :hanged 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
done by his agents, servants or employees.
Signed: z 1 BY r - , ,
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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR' " CSR' BUILDER BY
DATE - 195_4_
Contractor's
License No.
AUTHORITY
r
n
Lot
Bl.
Subdi-
vision
,f
er
'
Value of
Project
$
Amt. of
Permit
$
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building_
Architect
Contracto
or Builder
Legal
Descriptic
Address
Building
MIAMI SHORES VILLAGE, FLORIDA
1
PERMIT N° 10841
Work to be performed under this Permit_
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device descried 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 :hanged 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
done by his agents, servants or employees.
Signed: z 1 BY r - , ,
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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR' " CSR' BUILDER BY
DATE - 195_4_
Contractor's
License No.
AUTHORITY
MIA141 jHORES VILLAGE, FLA.
ADDRESS c � �� A�
INSPECTION r a l'
TIME READY G z;"' )
N9 5859
REMARKS:
INSPECTOR �' �� DATE ' 7-7
Permit No
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 work.
Owner's Name and Address__ ____ __ Street_ __9
Registered Architect and /or
Employing Plumber's N
ngin r__
«n.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING r;bsoi1IT
Location and Legal Desc tion Lot ______........ _________________ - ____ _- Block_____ Subdivision
Street and Number where work is to be performed- No.______ - -____ _ Street
State work to be performed and purpose of building (By Floors)
New Building _.___ Remodeling____ Addition
Amount of Permit $
t iy Conunission Expires
Date
- - -- -- Z:No. - f2O A Street_ 7
Type of Tank Capacity Gals.
Sind Septic Tank________
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City -Well
Repairs No. of Stories . . ......................
Size of Soakage Pit
( Sign
bing Inspe
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 bus com-
plied 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 such sub- contractors, work to be 5, armed under this permit, as are
Limped n Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
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
tbesein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when ouch re- inspection is made • necescary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
Telma
SINKS
SLOP
SINKS
LAUNDRY
TUBS
INAS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIOT
CHUCK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
_ - -_
CH6CG
Permit No
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 work.
Owner's Name and Address__ ____ __ Street_ __9
Registered Architect and /or
Employing Plumber's N
ngin r__
«n.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING r;bsoi1IT
Location and Legal Desc tion Lot ______........ _________________ - ____ _- Block_____ Subdivision
Street and Number where work is to be performed- No.______ - -____ _ Street
State work to be performed and purpose of building (By Floors)
New Building _.___ Remodeling____ Addition
Amount of Permit $
t iy Conunission Expires
Date
- - -- -- Z:No. - f2O A Street_ 7
Type of Tank Capacity Gals.
Sind Septic Tank________
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City -Well
Repairs No. of Stories . . ......................
Size of Soakage Pit
( Sign
bing Inspe
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 bus com-
plied 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 such sub- contractors, work to be 5, armed under this permit, as are
Limped n Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
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
tbesein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when ouch re- inspection is made • necescary by improper notice for inspection, or faulty
materials and /or workmanship.
Owner's Name and Address
Registered Architect and /or Engineer RA,
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.
DUI ou 1, ZEE j.) EA
Date
Name and address of licensed contractor //" L)/ 13(2o5 - 2 - C 7 .5 Dixie y
Location and legal description of lot to be built on: 105 S P/ [ �K L EL. eta
State work to be done and purpose of building (by floors) NlR.
'b_tl is.) G
�� P /fi T1o. i f s5/ err L Z '5y5, 7 "34
.;,44 s'.19
No 5aS street. _IV 1 3 -o
Co44c C/liSC,G'S ` (1iivrad)
u o D
Lot Block Subdivision r
Street and Number where work is to be done �_2. /vs Z49
F f2r D.2_431_5 W 4' .(41/
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of fo ndation Roof tiering
f
Estimated Total cost of improvements $ 6 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 �_1_c___fz Plea T SZ S �t . 7 3'e1' 5 J-
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 public notice
or notices as are required by the Act. The undersigned agrees to employ only such sub ntractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks
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.
Disapproved Date
Notary Public, State of Florida
(Signed)
Building Inspector 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of 7-
Building ;-
❑ DATE 195
PERMIT N? 5241 Contractors a
License No. 0
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Architect
Contractor ,
or Builder
Legal Lot
Description 1 B1
Address of
Building
Subdi-
vision
Value of
Project $
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 sta ents or specifications and that he assumes responsibility for work
done by his agents, servants or employees. 9 F` , . Fj` \
Signed. ,i "�. -. ,- - -_ BY:
INSPECTOR
Amount of
Permit $
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinal - toes 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 agent, servant or employee.
BY AUTHORITY
Dwner of
iuilding_
"rchitect
;ontracto
Buildel
.egg
)escriptic
"ddress
wilding
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
HUILDING ❑
F`LECTRICAL ❑ PERMIT N?
PLUMBING ❑ N® 9309
GOOFING 0
Work to be perforzned under this Permit
DATE
Contractor's
License No
BY AUTHORITY
195
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
lerefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
lrawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
ime 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 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 '- 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.
n accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
17
r
Lot
n
BI.
Subdi-
vision
f
Sq. Ft
Amt. of
Permit
$
Value of
Project
$
Dwner of
iuilding_
"rchitect
;ontracto
Buildel
.egg
)escriptic
"ddress
wilding
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
HUILDING ❑
F`LECTRICAL ❑ PERMIT N?
PLUMBING ❑ N® 9309
GOOFING 0
Work to be perforzned under this Permit
DATE
Contractor's
License No
BY AUTHORITY
195
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
lerefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
lrawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
ime 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 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 '- 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.
n accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
17