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174 NW 93 St- A APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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 V - / , 19.C�' ._ ,7(( Owner's Name and Address _. _._ _ _ . __. ____Qw Street. /l�! ./ Chairman Member _______ ___ Member Council Approved R e g i s t e r e d Architect and /or Engineer ..... Name and address of licensed contractor___ Location and legal description of lot to be Lot__ . Block Street and Number where work is to be done MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT ton: Subdivision State work be done and purpose of bui ' g (by floors ). _ and for no other purpose. New Building Remodeling Addition Repairs — No. of Stories To be constructed of Kind of foundation____ Roof Covering_ Estimated Total cost of improvements $ 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 foi said building. All notices with reference to the building and its construction may be sent to--- The undersigned applicant for this building permit dot 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, Pennanent 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks 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 and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described cons uction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him • te, are e. Permit No._ " Date _._ ° r. '7_- Read, Sworn to and Subscribed before me. Disapproved � l Date (Signed) (Signed Building Inspectors My Commission Expires__ to me well known, Notary Public, State of Florida PL ING BOARD__ __. DATE Member Member Member _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. Application is hereby made for the approyal 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. - 7 Owner's Name and Address - -L_ r --. - - - -. -- - - - --- - - -- No.. /2 ... Street4t Reglitered Architect and /or Engineer.._ _ __. Name and address of licensed contractor___. Location and legal description of lot to be ilt on: Lot Block Subdivision 7 ./ 7 ed-- State work to be done and purpose of building (by floors)._ _ __ Street and Number where work is to be done Member Council Approved .__ MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT PLANN I G BOARD -Date (Signed) _ Building Inspector ; My Commission Expires. DATE Chairman _. _._ _ . Member Member Member ,19..6 . .7 and for no other purpose. New Building Remodeling Addition Repairs._ � No. of Stories To be constructed of Kind of foundation _- Roof Covering__ Estimated Total cost of improvements $ 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 foi said building. All notices with reference to the building and its construction may be sent to__ - - _ -- The undersigned applicant for this building permit doe 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, Pennanent 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 subcontractors, 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 cq CO Date _.__.. " /? ` Read, Sworn to and Subscribed before me. Disapproved / Date ..,` =�, Notary Public, State of Florida ( Signed) �I! - � ' Member 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 ❑ MIAMI SHORES VILLAGE, FLORIDA . . ELECTRICAL ❑ date - - —__ PLUMBING ❑ PERMIT N9 8964 ROOFING ❑ 0 Owner of Building -►- . , 4.- Address of Building Architect Contractor or Builder Legal Lot Description B1 f a y 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 applica- tion 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 or if the plans are changed without authorization. A further condition upon which this d above assumes the responsibility for a thorough knowledge of the ordinances and s or drawings or in the statements or specifications and that ho assumes respon at any time if the work is not done in compliance with such ordinanc permit is granted is the understanding that the contractor or builder na regulations pertaining to the work covered hereby whether shown on,the sibility for work done by his agents, servants wripploye Signed /,� ` t 0 CONTRACTOR or :BUILDER Work to be performed under this Permit 14 F ;r . 4 (INSPECT ') . BY Contractor's �s t ? License No. .' " t , -� Subdi- vision Sq. Ft. Se` r+c_. Value of "" 11 Amount of Project $ 11 Permit $ In consideration of the issuance to me of this permit I agr tp perform the work covered hel'L4gtier in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawl s, Statements or specifications submittenst the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work d e either, myself, my agent, servant or employee. UTHORITY BUILDING MIAMI SHORES VILLAGE, FLORIDA 0 ELECTRICAL E:1 PLUMBING Li PERMIT . N? 8963 ROOFING 0 0 Owner of Building Architect Contractor or Builder '/ e • 14,„ IS it_tn,_ ,^-44tOriel 1 ., Legal / Lot I 1 Description I B 1 Address of Al: I 4...o Building / — 4 ) -2' i 3 CONTRACTOR or BUILDER Work to be performed under this Permit ft. • / •■•••■ BY Date I "• Contractor's License No. Subdi- vision Sq. Ft. Value of 11 Amount of Project $ ' Permit $ AUTHORITY t , C‘ j3b 1■.! %or— t? 6 I t( 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 applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with art 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 withcut authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above sumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered her by whether hown on the plans or rawings or in the statements or specifications and that he assumes respon- sibility for work done by his agent, seiyants employees li i ?a , • Signed SPECTOR) BY t In consideration of the issuance to me of this permit I afire qr perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawin Atatements or specificatiens submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work dop b either, myself my agent, servant or employee.