720 NE 94 St (4)BUILDING
ELECTRICAL
PLUMBING
ROOFING
Address of
Building
CONTRACTOR OR BUILDER
MIIAMI SHORES VILLAGE, FLORIDA
PERMIT
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
N° 5730
DATE i ' 19
Contractor's -
License No. 1
Work to be performed under this Permit
B1
Subdi-
vision
Value of
Project $
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 o r specifications and that he ;assumes respon-
sibility for work done by his agents, servants or employees.
Signed f 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 ao•
cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee.
AA �
BY AUTHORITY
Amount of '
Permit $ `
A•807
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 Law= of the State of Florida, all ordinances of Miami Shores Village ?nd all rules and
regulations of the Building Division of Miami Shores Village shall be ea :Tiied with whether herein specifier) not. A cope of approved
plans and specifications must be kept at building during progress of the work.
Date - -- -. 1
Owner's Name and Address # Z _ 6_1 __ ____ No..._ 7>'r!
Registered Architect and /or Engineer
Name and address of licensed contractor / Ce(/ Cr, �,vL _ ___
Location and legal description of lot to be built on:
Lot I6 ! f Block Subdivision
Street and Number where work is to be done 1 )4) #t/
State work to be done and pu ose of building (by floor
i....-•"".--- New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ / QZ1 -__ Amount of Permit $
- -- - - --
Zone cubage required .Plan Cubage
Size of Building Lot
Distance to next nearest building
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said uilding. All notices with referen to the building and its construction may
be sent to - 3I Z / 1C /G O. /42Ae
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori
and has complied with the provisions thereof, and will require similar compliance from all contractors or su
in the work to be performed under this permit; and will post or cause to be posted for i pection on the s'
or notices as are required by the Act. The undersigned agrees to employ only such su. • actors, on
permit, as are licensed by Miami Shores Village. /
Remarks (Sign :
Disapproved .. -. Dat
(Signed)
MIAMI SHORES VILLAGE
Building Inspe; or
Chairman ___ ___ __ ___ _
Member
Member
Council Approved
ANNING BOARD_ .__._._ _ .. DATE
and for no other purpose.
as an employer
manent Supplement,
employed by him
ch public notice
rmed under this
contracto
e of the wo
ork to be
19 - -C T
7-f -
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
Notary Public, State of Florida
My Commission Expires
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.
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 5 •` 0 Date 7- 7- 3-4, Read, Sworn to and Subscribed before me.