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PAINTBUILDING ELECTRICAL PLUMBING ROOFING ❑ PERMIT N° CONTRACTOR OR BUILDER MIAMI SHORES Owner of , Building ' Architect Contractor or Builder Legal Lot Description B' Address of Building � VILLAGE. FLORIDA 6442 .4-z . DATE 195 Contractor's License No. Work to be performed under this Permit Subdi- vision Value of Project $ Permit $ Amount of 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 conditon 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 sta ments or specifications apd that he assumes responsibility for work done by his agents, servants or employees. 1; 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 subm9tsd 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 cr employee. BY AUTHORITY 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 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. 4 .... - Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done ! 0 0 0 /N.& 4 State work to be done and purpose of building (by floors) STATE OF FLORIDA, COUNTY OF DADE. ss. Disapproved Date (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT 1 ate...... .`-....." • No 1 l s... Street 1 0 O 0 16 and for no other purpose. New Building Remodeling . .- Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering 0 0 Estimated Total cost of improvements $- - - -j - �� 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 pennit 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 site of the work such public notice or notices as axe required by the Act. Village. agrees to employ only such sub, tractors, on worky to be performed under this Remarks (Signed). /// permit, as are licensed b y Miami Shores i age. 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 him stated are true. Permit No._ 6 V V 'L- Date 1 'L ° VI 7 ead, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector i7 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. Owners Name and Address -_- 1 ,2..4, ./C AC i2. - Regt tered Architect and /or Engineer Chairman _ Member Member Council Approved Building st' ector 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 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. No., O_Q_././E Street._ Date 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/. 6 1-- __ -6 ' State work to be done and purpose of building by floors) and for no other purpose. New Building Remodeling ___. ._ Addition Repairs No. of Stories / To be constructed of Kind of foundation Roof Covering O Estimated Total cost of improvements $__ -__ Amount of Permit $ `� Zone cubage required _ -Plan Cubage _. Distance to next nearest building_ ___ . _ _______ Size of Building Lot 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 perrnit dot 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 hint 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 suc u bcontractors, work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed 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 him stated are true. 7 Permit No l.� U � � Date ____'o — 7- 4 7 ____ Read, Sworn to and Subscribed before me. Disapproved ____ _ .._ Dat Notary Public, State of Florida (Signed) My Commission Expires__ PLANNING BOARD __ . DATE 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. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 3 /O q9 Job Address /DO NE ` z Tax Folio Legal Description Historically Designated: Yes No /C 1 Lessee / Tenant ) / M/ / 42/ G E Owner's Address / 0 iV 9' Z;(te '' Phone 3 Zip ` T ' Contracting Co.,)( eahli - Address Qualifier - State # Municipal # Architect/Engineer Bonding Company Mortgagor Permit Type (circle o BUILDING LECTR N WORK DESCRIPTION— ,x7,i .go,6Z `ktu/6 64,k v- so/ ime.yl do/ hg co fa tii#i Square Ft. WARNING TO OWNER: YOU MUST RECORD A NOTICE OF C PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTb OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE 0 Application is hereby made to obtain a pennit to do work and installation will be performed to meet the standards of all laws regulating construction PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT RADON Master Permit # ID YO OBTA lthet' derstf C.C.F. 1 C v NOTARY 5 - ..N,. SIGN /4 lir e • INSULT INT YOUR riff YOUR LENDER I certify that all work •ed for ELECTRICAL OWNER'S AFFIDAVIT: I certify that all the foregoing information is ac laws regulating construction and zoning. Furthermore, I authorize the above -named con, to )ate Date APPROVED: TOTAL DUE ••■, Zoning Building �P 9/i6)11 Electrical Mechanical Plumbing Structural Engineer