285 NE 95 St (2)BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 7100
B
Address of
Building w �'
DATE
Contractor's
License No.
195
Work to be performed under this Permit
Subdi-
vision
Value of
Project $ /
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 a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings cr in the tatements or specifications arid that he assumes responsibility for work
done by his agents, servants or employees.
Signed BY •
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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
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 oa Florida, all ordinances of Miami Shores Village and all rules and
regulations of the iuilding 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.
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Disapproved
(Signed)
Bui • mg Inspect
Chairman
Member
Member -- •--- _._....._.__..
Council Approved
MIAMI SHORES VILLAGE
.. Date.••_....._ ti '_� ...._ 19..
T Address .... �°�' ` ._. No. 421. Street_...) ✓.C......._ '�-!f l-,
Owner's Dame and ••
Registered Architect and /or Engincer
Name and address of licensed contractor i /44., - - Q:-22:e:e "' 2..0_./ 1.2 / T.:.eill--
Location and legal description of lot to be built on: yy�
Lot .E a .44.4 .C Block...... -+l Subdivision �'l..[�2 At-eg/ C...e_.1...._.. / /VQ
Strri' and Rumber where work is to be done....,,_„,
State work to be done and purpose of building (by floors)....._.
NNINC BOARD _.._ DATE
Notary Public, State of Florida
My Commission Expires _
...__.. _..__ 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 $ 2,51 ne Amount of Permit $. ,..f
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 \Vorkmen's Compensation Act, being Section 5966, Compiled General ws of Florida, Permanent Su »lenient,
and has complied with the provisions thereof, and will require similar compliance from all contr • s or sub - contractors employe by him
in the work to be perfonned.under this permit; and will post or cause to be posted for i sp ti the site of the w• k such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such su a f work to be • rformed under this
pennit, as are licensed by Miami Shores Village.
Remarks . —..... (Signed)
, 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 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 _.._L true. l
Permit No.. 79 Date —/ Y/ —7 .L - _ Read, Sworn to and Subscribed before me.
to me well known,
Member _......._._......_..._
Member —
Member ...._............_. Y.._ ..__..» — -- —
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 in'pcc•tion 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.
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