170 NE 94 St (8)MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑ Date � 19 '
ELECTRICAL ❑
PLUMBING ❑ PERMIT N° 9256 Contractor's
License No.
ROOFING ❑
Work to be performed under this Permit
Owner of
Building o
Address of
Building
2
//
Architect
Contractor
or Builder
Legal Lot II
Description II BI
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
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 respon-
sibility for work done by his agents, servants or employees. , r ,
(INSPECTOR) BY
In consideration of the issuance to me of this permit 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, jny agent, servant or employee.
CONTRACTOR or BUILDER
Subdi-
vision
Sg Ft .>
Value of ` Amount of
Project $ 1 �' %� II Permit $ /1
BY AUTHORITY
APPUICATO®N1 FOR ! UULDDNS PERMUT
Application is hereby made for the approval of the detailed statement ur we 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 ilnilding 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 Progreso of the work.
Owner's Name and Address k- 6 1AIti L:10 _ _ No. ..._ 1..7.L'.....__. Serest. L . r....
R egistered Architect and /or Engineer .,., . ,. ». !I
Name and address of licensed tenor actoe...Ic.L1.t.L',...1? -'f'
Location and legal description of lot to be built on:
Lot e . 4' 1 Block atca Subdivisionrn s... 1 1 _ 3 APES A3 °7
Street and Number where work is to be done / ' 1✓ � ... `x' Y .... S . ! .. : _._ . .�EX 1s /Ai L" iC E ; i b NC'
State work to be done and purpose of building (by floors)...A .P144? l.'.? 7 ' 6?42.0
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 $ 33.75 5 Amount of Permit R r3 r.eo
Zone cubage required Plan Cubage
Distance .to next nearest building Size of Building Lot _ .................- ......
,faxirnum 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 un,icrsigncd 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, Prnrr►ne-nt 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
pcnnit, as are licensed by Miami Shores Village.
Rem,uks..J1.2...A &ALe OF NCSr >c (Signed) .._..
/7
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
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 car fully read the foregoing application, and that he did sign the same, and
therein by him slat d e ..
Y
Permit No..
Disapproved
(Signed)
M0AMO SG-iDRES VoLLAGE
BUILDING INSPECTION DEPARTMENT
ate
Building inspector
PLANNING BOARD DATE
Chair:nrn
Member
Member .. _.. – ...._..._.— ...._.......
Council Approved Date
NOTE: A charge of $1.00 will be made for making corrections
the I'Lrnnir Ilu.rrd.
A rc.insjwction Ice of $1.00 will be charged
materials and /or workmanship.
,Idy, 7///
to me well known,
at all facts
Member
Member
Member -- • - . - -..
Disapprov Date
or changes to this application after approval has been obtained frmn
Read, Sworrf�t �,*.. 6,�� rr 1
' - `��/
Notary Public, t INv i A ; , • '41. LIC STATE OF FLORIDA
My Commission Eupires AAY CmM. 1 . S5.if1i,I.Lf311ZS .J.e.4.4-lRil•.z_ •
, nr inrn ,F.;-,, r- . ,0..,. len
when such re- inspection in made necessary by Improper notice for inspection oa faulty