1181 NE 97 St (13)BUILDING
ELECTRICAL
PLUMBING
Owner of
Building ✓ '
Architect r i +
Contractor c' ,
or Builder
Legal Lot
Description -a..
' . ° d' 4A
);Ne
t" CUIVTRACTunt- (5R BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE • icr ../'' / --
PERMIT N? 10269
Work to be performed under this Permit
Bl.
In consideration of the issuance to me of this permit I agree to'p r
pertaining thereto and in strict conformity with the plans, drawings, stlumen
In acceptir this permit I assume responsibility for all work done by either, i yse
Subdi-
vision
�4.
Address of � ^ � ��� � � .::1... Value of
Buildin g /1 � Project $
BY
This permit is granted to the contractor or builder named above to construct the building or to install the equipment
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be perfo
drawings, statements or specifications that may have been submitted to and approved by the proper municipal thorigg
time if the work is not done in compliance with tuch ordinances or if the plans are changed without authorizat
granted is the understanding that the contractor or builder named above assumes the responsibility f a thorou
pertaining to the work covered hereby whether shown on the plans or drawings or in the state nts ifica
done by his agents, servants or employees. )
/ 4
Signed•
Contractor's
License No.
Amt. of
Permit
e. hereunder in compliance with all ordinances and regulations
cations submitted to the proper authorities of Miami Shores Village.
my agent, servant or emplgyee.
AUTHORITY
is
195_.-C
ribed in the application
liance with any plans,
ay be revoked at any
n which this permit is
e ordinances and regulations
he assumes responsibility for work
a
i
,' O ; ! O
L. k (1
■
Registered Architect and /or Engineer.
New Building .ri Remodeling
To be constructed of Kind of foundation
Estimated Total cost of improvements $_
Zone cubage required
Distance to next nearest building i
Maximum live load to be borne by each floor
STATE OF FLORIDA,
COUNTY OF DADE. ss.
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
MIAMI SH o RES 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, whethlr herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date , 19=
Owner's Name and Address No Street
Fe
Addition
Chairman
Member
Member
Council Approved Date
1
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)
PLANNING BOARD DATE
Notary Public, State of Florida
r t`
!
and for no other purpose.
Repairs No. of Stories 1'
� Roof Covering --- _ -
ount of Permit $
_Plan Cubage
Size of Building Lot _
i7-
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 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) _____ __ _______
__
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 Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector My Commission Expires
Member
Member
Member
Disapproved Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
0
Df
r
for
er
Lot B
BL S
Subdi-
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner
Buildin
Archite
7-ontrac
or Build
Legal
Descrip
Addres
Buildin
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 11701
DATE
Work to be performed under this Permit
This permit is granted to the contractor or builder named above to construct the building or to install equipi ant or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the war Q✓ be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper m 'spa,; a rities. 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 aut ' atiart A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility fo Irgh knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the state n 'cations and that he assumes responsibility for work
done by his agents, servants or employees.
195
Contractor's
License No
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 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