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67 NE 94 St (8)Owner cf Building_ Architect cnt_ artor or Builder_ _ - - -- Legal Lot Desc. i ton CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ DATE 1 95 T ELECTRICAL ❑ PLUMBING ❑ PERMIT N9 8685 Contractor's License No. ROOFING ❑ Work to be performed under this Permit_-_ _ _ _ Bl. Subdi- vision sq. Ft. Address of Value of Amt. of Building Protect $ Peru it This permit is granted to the contractor or builder named above to construct the buildirg or to install the equipment or d .vice described in the application here or 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 he revoked at any time it tte work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition cpon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge o' 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 responsibility for work done by his agents, servants or employees. Signed: — BY INSPECTOR In consideration of the issuance to me of this perrnit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plane, 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, my agent, servant or employee. BY AUTHORITY STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE 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 cf 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 Owner's Name and Address No Street Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block_ Subdivision Street and Number where work is to be done ;' • State work to be done and purpose of building (by floors) / /,''; • 'w /7/ ' , ' i ;7/ /"//'^ l — – "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 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 Workmen's Compensation Act, being Section 5966, Compiles 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 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 (Signed) h 47 , ,19 Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- ncared — — — — - -- — — – - 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 :herein by him stated are. true. 'ermit No � __ Date _� _____; / Read, Sworn to and Subscribed before me. 3isapproved __, i Date � Notary Public, State of Florida ( Signed) Building Inspector My Commission Expires PLANNING 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPL C TIDN FOR ='LJBL MG PE= MIT 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 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. Owner's Name and Address.. Registered Architect and /or Engineer Name and address of licensed contractor f Disapproved �� ' Date O (Signed) ... Building Inspector 792 G i��u Location and legal description of lot to be built'on: Lot Block Subdivision Street and Number where work is to be done / Street , 19 State work to be done and purpose of building (by floors ) y/ f�� t r _ and fgf 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 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 Workmen's Compensation Act, 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 s a of the works 1 public notice or notices as are required by the Act. The undersigned agrees to employ only such ractors, on ork to b p ormcd under this permit, as are licensed by Miami Shores Village. _ Remarks (Signe /' `�Fc. - ��ei � 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 hi stated are true. - Permit No Date t° Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires /PLANNING BOARD DATE Chairman / PLANNING 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 th . 'tanning 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.