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438 NE 96 St (6);UILDING LECTRICAL 'LUMBING )wner of ; uilding architect MIAMI SHORES VILLAGE, FLORIDA DATE 194 , PERMIT N? 8541 Work to be performed under this Permit 4 fT .e . Contractor's License No. 1_ Th ] ontractor •r Builder .ega1 Lot Bl. Subdi- )escription visio \`, address of f r *. `. f . • :, Value of de 1 Amt. of : uilding si Project Pen >., w, 444. T his permit is granted to the contractor or b i der named above .to construct the building or to install the equipment or devic described in the appli- ation herefor in strict compliance with all ordinanc pertaining thereto and with the ovule ding that the work will be perfornie in compliance with any .lans, drawings, statements or specifications that may have been submitted to anti apjxoved by the proper municipal authorities. This Permit may be revoked t any time if the work is not done in compliance with such ordinances or if thefplaais are changed without authorization. A further condition upon which this , ermit is granted is the understanding that the contractor or builder named aboke Assumes the responsibility for a thorough knowledge of the ordinances and egulations pertaining to the work covered hereby whether shown on the plans. rklrawings or in the statements or specifications Id that he assumes respen- ibility for work done by his agents, servants or employees. a ` . M Signed: INSPECTOR In consideration of the issuance to me of this permit I agree to perform' the work covered hereunder in compliance with all rdinances and regulations •ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper autlioriti s of Miami Shores Village. u accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY 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 Divis_on of Miami Shores Village shall be complied with, whether herein s ified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Name and address of licensed contractor va 4-11 - 1 / 1) ? 04 - Registered Architect and /or Engineer Location and legal description of lot to be built on: Lot Block Street and Number where work is to be done State work to be done and purpose of building (by Permit No Disapproved 4 (Signed) New Building MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT remodeling To be constructed of. J • Kind of fo undation Estimated Total cost of improvements $ s ue ____ Repairs Roof Covering - Amount of Permit Zone cubage required _Plan Cubage Size of Building Lot Building inspector floors )_ __ Distance to next nearest building 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 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 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 lis carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true Dat PLANNING BOARD Date S division 7 Chairman Member Member Council Approved )'cf Dat DATE No. Street Read, Sworn to and Subscribed before me. and for no other purpose. No. of Stories 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.