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660 NE 93 StBUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ Owner of ` Building `� `u �� s MIAMI SHORES VILLAGE. FLORIDA Architect Contractor or Builder Legal Description Address of Building CONTRACTOR OR BUILDER PERMIT N? 5047 Signed. Work to Le performed under this Permit ti 1 Subdi- vision Value of ` ' o Project $ INSPECTOR lY Contractor's // License No. 1 DATE ~ 195 r 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 � ° thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statement r specifications and t1`iatIhe assumes responsibility for work done by his agents, servants or employees. r' 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 tfi permit I assume iponsibility for all work done by eithsr, m lf, my agent, servant or employee. AUTHORITY I hereby be sent to__ Application is hereby 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, wheth 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 Addres. ..'..__.•._ � No No �'� Streeli W Iad Registered Architect and /or Engin• - ._._ -_ -_ / 4 .1 :1 le7 Name and address of licensed contractor.. �� �. I� - Location and legal desscr' tion of lot to uilt on: Lot/ v 4 - /4 Block. Street and Number where work is to be done- .i State work to MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT uil New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of founaon Roof Covering Estimated Total cost of improvements $ a9 ' 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 it - . e plans specifiea '�:� s for said building. it otices a he building and its construction may The undersigned applicant for this building . nnit do hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Ac , 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 ubli otice or notices as are required by the Act. The undersigned agrees to employ only such contractors, on}vork to be this permit, as are licensed by Miami Shores Village. Remarks (Signed) Date —/ ate z , I' 6./t7a 04/ ig4e.( Notary Public, State of Florida Read, Sworn to and Subscribed before me. and for no other purpose. STATE OF FLORIDA, COUNTY OF DADE. j 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 czc- 7 Disapproved (Signed) Building Inspector My Commission Expires PLAN ING 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. &JO" ..CTE.Ezr