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601 NE 96 St (7).► JOB ADDRESS IN SPECTION TI ME READY REMARKS : — IN SPEC BUILDING ELECTRICAL PLUMBING ROQFI 0 PERMIT Owner of Building • Architect — VILLAGE, FLA. N9 6414 MIAMI SHORES V%L MIAMI SHORES VILLAGE, FLORIDA DATE N° 5872 Work to be performed under this Permit DATE r' : t ' Contractor's License No. Subdi- vision Value of Project $ d above to construct the building or to install the equipment or device described in the applica- ereto and with the understanding that the work will be performed in compliance with any n submitted to and approved by the proper municipal authorities. This Permit may be revoked \nances or if the plans are changed without authorization. A further condition upon which this elder named above assumes the responsibility for a thorough knowledge of the ordinances and ti on the plans or drawings or in the statements or specifications and that he assumes respon- ! Signed: � . ' i r se to perform the work covered hereunder in compliance with all ordinances am regulations statements or specifications submitted to the proper authorities of Miami Shores Village. In ae ther, myself, my ages servant or employee. BY AUTHORITY Amount of Permit $ . 4=' /) INSPECTOR AO 130T Lot ' 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 Lawc 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 complied with whether herein specifiers c'. not. A copy of approved plans and specifications must be kept at building during progress of the work. Date_ /Y- O V / 2— Owner's Name and Address____" 4'!l _._____ 1 .1 4•. _C_'__2_ G - - _.. ___ _ Street__- _ ____ . _ Registered Architect and /or Engineer _ _ __ __ Name and address of licensed contractor 1` l_ e{.vf_________ Pe _47Zi,V __ P•_3Er®___ I__(4.!6 y "CI! !ST Location and legal description of lot to be built on: Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) _4 _.l I &'P / 7/0 A4'6 / `10� PE 'z._ PIow e S_fl ,4 /, e�tifel CI f oA 0 de ® if tt - #9.' and for no other purpose. New Building K Remodeling Addition Repairs No. of Stories To be constructed of C 4 5 Kind of foundation Roof Covering Estimated Total cost of improvements $. Amount of Permit $ 3 ®_ 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 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_g_ _ /_%i_____ R'O /N Si 011a F t ct ! ( Signed) i9. e. • � 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 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 g- 7 2— Date I/ — / 6 - (� Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida ( Signed) PLANNING BOARD Building Inspector ( My Commission Expires DATE , to me well known, 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.