750 NE 96 St (4)P e) ( " 9 MIAMI SHORES VILLAGE, FLORIDA
BUILDING DATE
ELECTRICAL
PLUMBING
Architect ,
f
Contractor },/r`
or Builder
PERMIT N° 4530
Work to be performed under this Permit
Owner of
Building
,r J
- 7' /v4 ` e` i
Subdi-
vision
Value of
Project
CONTRACTOR OR BUILDER BY
INSPECTOR
Contractor's
License No.
f "cue
Legal L'ot Bl.
Description
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described ap
cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in complian ith an
p lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may evoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon w 'eh 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 or the statemen »or specifications and that he assumes respon-
sibility for work clone by his agents, servants or employees. f " / ,/ 1
Signed. By r /
1
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 speci cations submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done b either asyself, illy vi rvantor employee.
Amt. of
Permit
AUTHORITY
9
Application is hereby made for the approval of the detailed statement in trio plans and specifications herewith submitted for the build
inc or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miami
Shores V Fl rid.t. 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 pot. 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
...AM ••• •••n,. ••rr. • .•rare! rw....., „n, e n
Name and address of licensed contractor � _. Q . e % d f. i t
9 1 z s N ”) 3 6 1) ✓ e
Location and
• ?al description of lot to bepuil on:
Lot ' , - - Block. 6 Subdivision 'VII a /1 5cW 4 1 c D5o 9
Street and Number where. work is to be done..._ 7 So !i ' _ S b S T
State work to be done and purpose of building (by [loots)_.._. .'11' a '` r
r
N G G G 4
a' '^ 1 "`/ 5 ..._.._ _.. NcP - . .._........._. and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories _
To be constructed of Rind of foundation Roof Covering
Estimated Total cost of improvements $ c ' Amount of Permit S. ._ °6 ..._..._......__......_ ..
Disapproved
(Signed)
c 6/ ■a
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 u nder s ign e d applicant for this budding permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida %Vorkinen's Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement,
and has complied e.ith the rovisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performe 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, oo work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA, ` 1' -'
COUNTY OF DADE. i ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowkdgmenu, 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 /� I are true.
. //� (
Permit No.. !�1..N 61 Date .... _.L.__ __ Read, Sworn to and Subscribed before me.
APPLICATION FOR BUILDING PERMIT
MIAMI SHORES VILLAGE
BUILDING INSPECTICN DE?ARTMENT
e e
Date -
Building Inspector
Dag b- L 3 - >�..�
No._ ° _ Street N-.+� S 6 • 57
n
Notary Public, State of Florida
My Commission Expires
to me well known,
PLANNING BOARD..._.._ _._ _._._DATE
Chai rman Member _.... t ti� .___....._.,_ _____..._........._..._
Merr,ber .._.. -.__ Member _- _._..- — __ _ _....___..........._...._-•-
Member — Member ...._ .___.__ -.._..
Council A pproved __._... Disapproved ......... Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has kern obtained tenon
the 1'l.tnnir,;; llu.trd.
A re•,nspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
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Mrlw t1 Nuu ...._
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