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10791BUILDING ELECTRICAL PLUMBING Owner of Building Legal Description. Address of Building Lot E PERMIT N? 10791 Work to be performed under this Permit r si t MIAMI SHORES VILLAGE Architect ;;ontrctctor < or Builder;',--d done by ' agents, servants or employees. CONTRACTOR OR BUILDER BL Vciiue of Project $ This permit is�anted to the contractor or budder named above to construct the building or to install the equipment or device described in the plicatson herefor in strict ' compliance e with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,__, time drawings, work is or not iee in ccompliance with such ordinances or if the lans v arechanged the without authorization A urthe upon p time the r�ditiora may u on which revoked dermit at any is granted is the understanding that a 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 or specifications and that he assumes responsibility or work his :_ Signed s} + t - u f BY r roi t` the Work sPE strict conformity with the plans, drawings „statements or s ecifi eyed hereunder t to in compliance r e with all ordinances and regulations pertaining th$ret k an in: e. In coma ;ratio .�f the issuance to me of this permit i agree to perform . cpv y cations submitted. to the prop0r'' authorities of Miami Shores Village. In acdeplig .this permit 1 assume, responsibility for all work done 'b either`, myself, m ° 'agent, servant or employee. Amow F' i r �`' FLORIDA DATE. _.: Contractor's License No Ault. of Permit AUTHORITY Owner's Name and Ad Registered Architect and /or Engineer_ Name and address of licensed contractor Location and legal .description of lot to be built on: Lot Bloat Street and Number where work is to be done State worms be done and purpose of building (by Remarks-- STATE OF FLORIDA, COUNTY OF DADE. f ss • pp Building Inspector • PLANNING BOARD. MIAMI SHURES VILLAGE BUILDING INSF ©N DEPARTMENT I;PPLICATION FfR BUILDING PERMIT Application is hereby made for the approval of the detailec statement of the plans and specifications herewith submitted for the build ing or other structure herein described. This application is matte in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the S to of Florid� all ordinances of Miami Shores Village and all rules and .regulations of the Building Division of Miami Shores Village sh be compli ed with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progre& of the rk. New Building Remodeling To be constructed of Kind of fo dation 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 permit, does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compenisation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and require similir compliance from all contra �,• —s � .. euiployed by him in the work to be performed under this permit; and post or cause tv be posted for . . • on the site of the work eh ublic notice or notices as. are required b the Act. The undersigned agrees to empl°Y only such subeo _ < etors, on work to be orneea under this permit, as are licensed by Shores Village. • _' Before me, the undersigned authority, a. notary. public, duly authd ed to administer oaths and take acknowledgments,' personally ap-' Feared to Me well known, and who, being by me first duly sworn, upon oath deposes and says tat he is the of the above described construction, that he has carefully read the forego application, and that he did sign the same, and that all facts therein by him stated. axe true. Permit No Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public., State of Florida (Signed) My Commission Expires Chairman %' - ember Member 1t'tember Member bey Council A roved Date PProved NOTE: A charge of $1.00 *ill be made for making corrections or changes to this application after approval has been obtained from the Planning Board. 1 A re-inspection ,fee of $L00 will be eharged',when such re- inspects m is made necessary by improper notice for inspection or faulty materials and /or workmanship. r DATE Date