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402 NE 95 St (8)BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA ❑ PERMIT N? 5119 � L CONTRACTOR OR BUILDER Work to be performed under this Permit DATR i Contractor's License No. Subdi- vision Value of Amount of •� 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 cr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. j Signed (, t y �--.. ... -- , .� 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 Vilkige. In ac- cepting this permit I assume responsibility for a 1. work done by either, myself, my agent, servant or employee. BY AUTHORITY 7 t 195 4 ",J (. e P • MIAMI SHORES VILLAGE c,57-9,,o9 BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement in Inc plans and specifications herewith submitted for the build - ine or other structure herein described. This application Is made in compliance and conformity with the Building Urdinanee of Miami Shores Florida. and all provisions of the Laws of the State of Florida. all ordinances of Miami Shores Village and ill rules and regulations of thc Building Division of Miami Shores Village shall be complied with, whether herein specified of not. A copy of approved plans and specifications must bc kept at building during progress of the work. Date O d • AckeD' wner's Name. and Address No. 5tree 5S Registered Architect and/or Engineer . Name and address of licensed contractor . • Location and legal description of lot to be built on: /A. Bock.'? Subdivision e Street and Number where work is to be done •Wc State work to be done and purpose of building (by floors) / ...— — New Building RemodCling. — Addition.. No. of • Roof Covering. — To be constructed of Kind of foundation.— Estimated Total cost of improvements $ Amount of Permit S. I ' / Zone cubage required Plan Cubage Distance . to next nearest building Size of Building Lot Maximum live load to be borne by cash 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 fur this building perinit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida %Vorkinen's Compensation Act. Section SOK Compiled - General Laws of Florida: Permanent Supplement.-- anti has complied with the provisions thereof, and will require similar compliance from all coritrict ciii ariub-Ceintractors employed by him --- in the work to bc 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 subcontract° on work to be performed under this pertnit. as are licensed by Miami Shores Village. 7:-, Reollks (Signed) --, / 7 : . eZ'DE /fee STATE OF FLOIlIDA., 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 eonstruction,that he has carefully read the foregoing application, and that he did si_ thesame, and that all Lacks_ therein by him stated are ue.. - Read, Sworn to and Subscribed before me. !• Permit No ?--/Ii Date (Signed) - Disapproved Date Building Inspector PLANNING BOARD and for no other purpose. to me well nown, Notary Public, State of Florida My Commission Expires. ----DATE Chairman Member Member /if ember Member . Member Council Approved —Date Disapproved — - — .Date :C.JTE: A charge of $1.00 will be made for making corrections or changes to this application after appmval has hem obtained from the I'lannir.;.: lluard. A re Ice of 11.00 will be charged when such re-inspection is made necessary by Improper notice foe inspection ye faulty materials Ana i or workmanship.