PAINTMIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: 5- g" a
OWNER'S NAME: Abi (, t (hit 'HONE: dyt 5 15� -
ADDRESS: /01) N 99` -(2/
Garage Doors
Railings
All brick (simulated or regular)
/111A
Stucco Banding
Any other stucco features
Accessory'Buildings
Other
Building Offi ial
Date
D
ADDRESS OF SITE: /00 4/ E I9 Q7 q i 6 3 s D
CONTRACTOR & LIC NSE (if licable) (' \ �` �� C� er }� Ea)
COMPANY NAME: ar Seivi CR PHONE :3 ?S" S - c").S
* * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
was 7 5) It' _ /Wi S Apr►co-
Fascia N),Q
Drip Cap/Drip Edge
Soffit � I
Roof OA
Flower Bins Al 1,t /s Apr e!1-t'
Shutters UA ■ V
Awnings ft) 17
Chimney N16
Doors and door jams 01)11∎ -e
Vit\V'
Fences [A1\ -e
Decorative Metal 6,03
kj
z
73 5% //
AhOet 5 4pv(&v-)--
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate
a hat all work will be done in compliance with all applicable laws regulating
c .
ruction zoning. I authorize the above -named contractor, if applicable, to
work . F ermore the Tint colors will be as per the attached
' Ij if
i
Si : r ' of owner Date ignatu of Contractor Date
* * * * ** *:************:************ * * * * * * * * * * * ** * * * * * * * * * * * * * * * * **
APPR • ED:
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
Miami Shores Village Building Permit
.1 10050 NE 2nd Avenue
\r' Phone: 305 - 795 -2204 Permit Number: BP2002 -905
Printed:5 /10/2002
Applicant: ABIGAIL WILLIAMS
Owner: WILLIAMS. ABIGAIL
JOB ADDRESS: 100 NE 99 ST
T Contractor Contractor's Address:
_ - Local Phone:
Parcel # 1132060132280 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOT 13 & W1/2 LOT 12 & LOT 14 BLK 17 LOT
Fees:
FEE2002 -2676
FEE2002 -2677
FEE2002 -2678
Permit Status: A proved Permit Expiration: 11/6/2002
Work: EXTERIOR NTING AS PER AGREEMENT
Signed:
Description Amount
Building Permit Application Fee $60.00
CCF $1.20
Notary Fee $5.00 .
Total Fees: $66.20
Signed: (Contractor or Builder)
Construction Value:
$1,300.00
Page 1 of 1
Total Fees: $66.20
Total Receipts: $0.00
If there is. no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all
ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to
and approved by the proper municipal authorities. 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
authorization. A further condition upon which 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 in the statements or specifications and that he assumes responsibility for work done
by his agents, servant employees.
(INSPECTOR) BY:
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 responisibility for all work done by either
myself, my agent, servants or employes.
BY:
'7.11' 0 05 /1 1r 02 66.20
£0991:'
FLORIDA Lill'
----- Me Sunshine Stair
-I
ABIGAIL PRICE •
100 NE 99 STREET
MIAMI ORES, , L----#4-1.38-0000
3 . .
0 _ 2 i - Y) F 5-00
06-n-1990
P6' I- 00-S9-60 03-2 -1996
CLe.
IVER'
99?j:
i RACTOR `
Name C YI Z
`
p- 0
0 3 5
5 -5-..; A
Address 1 S
• T
S-
Telephone 305 2
25=52 y
Qualifier Name-
PROPERTY OWNER ii II ..
Name A b `Sni i C ? \ c— W i � vl
1 C04 S
Address /00 �
Wu' S - 's t ►
k \ c 3 ?tQ'
Home Telephone 3 v s"- - 7 5 5 q
Business Telephone 30 5`` - g-71,-- ?G, -( /. /
Fax 305- _ SOU.- 72!`f.
TYPE OF MANAGEMENT (✓ )
New Construction Enclosure
Alteration Exterior Repair
Alteration Interior Demolish
Relocation of Structure Shell Only
Foundation Only Add'l Attachment
Other Add'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Subdivision
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address: i 0 U [; 1 >d-Ye Gi1M \/ S�G -e 1 2L 3 i 3 "
Address Apt. City State , Zip
Folio Number ,Description of Work -- e.)(+441.1 \ Y1a'1Y1
Lot Block
PB PG Zoning ms i .4 CL9 — Linear Feet
Current Use of Property fc St 4d-g e Square Feet Units / Floors
Proposed Use of Property 6 (J�1�1�(�. X Value of Work P 13o 0 i Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other Pel∎
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
PERMIT CHANGE (✓ )
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No. 61' -3OOc °la
ENGINEER
Name
License No.
Address
Telephone
Fax
TYPE OF MANAGEMENT (✓ )
New Construction Enclosure
Alteration Exterior Repair
Alteration Interior Demolish
Relocation of Structure Shell Only
Foundation Only Add'l Attachment
Other Add'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Subdivision
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address: i 0 U [; 1 >d-Ye Gi1M \/ S�G -e 1 2L 3 i 3 "
Address Apt. City State , Zip
Folio Number ,Description of Work -- e.)(+441.1 \ Y1a'1Y1
Lot Block
PB PG Zoning ms i .4 CL9 — Linear Feet
Current Use of Property fc St 4d-g e Square Feet Units / Floors
Proposed Use of Property 6 (J�1�1�(�. X Value of Work P 13o 0 i Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other Pel∎
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
PERMIT CHANGE (✓ )
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No. 61' -3OOc °la
ENGINEER
Name
License No.
Address
Telephone
Fax
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Subdivision
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address: i 0 U [; 1 >d-Ye Gi1M \/ S�G -e 1 2L 3 i 3 "
Address Apt. City State , Zip
Folio Number ,Description of Work -- e.)(+441.1 \ Y1a'1Y1
Lot Block
PB PG Zoning ms i .4 CL9 — Linear Feet
Current Use of Property fc St 4d-g e Square Feet Units / Floors
Proposed Use of Property 6 (J�1�1�(�. X Value of Work P 13o 0 i Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other Pel∎
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
PERMIT CHANGE (✓ )
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No. 61' -3OOc °la
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation.. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1S Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
ac•• •ante with Sect ; 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and 1,,/ .. i 4
C !, sing a Contract
ir OP , � rI O MIAMI-DADE STA • F FLORIDA, COUNTY OF MIAMI -DADE
Print Na
worn to . nd subscribed before me this
/PIA A I _
ignature oft ota�r pu -- . - •v,l e'da
CC736 i
�
OF ca
Personally known OR, Produced Identification Personally knoWn • OR, Produced Identification
Type of Identification Produced: 4)) )_1 4 0 0 0 r / O 'pe of Identification Produced:
SEAL:
SEAL:
ame
Sworn to and subscribed before me this
Signature of Notary Public - State of Florida
PERMIT APPLICATION
gnature o Contractor / Qual
day of
ELECTRICAL
TYPE
Minimum Fee
QTY.
T1'PE
Dryer
QTY.
'i' '1'i;
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv, Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECI- IANICAL
TYPE QTY.
Minimum Fee
TYPE:
Condensate Drain
QTY. TYPE:
Generator
QTY. TYPE QTY.
Refrigeration, Tons
A/C Central, Tons
Cooling Tower
- Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
- Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
PLUMBING
TYPE
A/C Condensate
Q.l.y.
'l'V I'E
Drains, Roof
QTY.
,l.vPE,
Miscellaneous Fixture
QTY.
.1.x,11.:
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
B ,
DAT
Zonin:
# 2M
)—
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
�/
3 /�d
12--—
Building Official
• •
_
,/.,,&
Page 4
OFFICE USE ONLY
EIC LIST
• OWNER - BUILDER FORM
(Attach)
O FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
to CONCURRENCY
(New Construction)
LI OTHER
(Specify & Attach)
PERMIT FEES
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
® PROOF OF OWNERSHIP
(Attach)
• HRS / DERM APPROVAL
(Septic / Sewer)
CI IMPACT FEE
(New Construction)
L OTHER
(Specify & Attach)
Metropolitan Dade County (C.C.F.) $ / • o2 0
`�• DO
REVIEWED AND PREPARED BY:
(sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
CI CONDO ASSOCIATION APPROVAL
(Attach)
BPR APPROVAL (Restaurants)
CI CONTRACTOR REGISTRATION
(On File)
TOTAL $ 6e(e • c s°
LI §,SUING OFFICIAL
DATE:
CONDITION OFAPPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address b/d N ?9 Tax Folio
Date
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant /97 - -S
Owner's Address /0 () Nv 9 < --
Contracting Co. 0 v-1 N I_ / Address
Qualifier SS#
State # Municipal # Competency #
Architect/Engineer Address
Bonding Company Address _
Mortgagor Address
605J c 6
Notary as to Owner and/or Condo President Date
My Commission Expires:
` p,AY n� 6 CFFiCtAL NOTARY SEAL
O r z - {i SCC T T W DAVIS
N ' S r COMMISSION
CC255237 NUMBER
�j a „_;r
MY COMMISSION EXP.
OF DL JAN. 26 1997
Square Ft. Estimated Cost (value) CT
Master Permit # q-3 o D
Phone 3 U s 7 s e S/
Peach Dust (1)
Phone
B -13
Permit Type (circle one): BU ING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
�AV US .. FX - 7 - °4/ 6�
WORK DESCRIPTION
(Ai g,„ Li / 1/A
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
la - { lating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signape of owner and/or Condo President pfite Signature of Contractor or Owner- Builder Date
Notary as to Contractor or Owner- Builder Date
My Commission Expires:
FEES: PERMIT (e()c RADON C.C.F. , S V NOTARY TOTAL DUES. (J
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 5220
Work to be performed under this Permit
Subdi-
vision
DATE
Contractor's
License No.
Value of Arnt. of •
Project Permit
194
This permi is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. 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 authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assuples the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drwings or, n the state24is or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. ' " ' """ ° ,,....1
Signed. r'a B y
V P
... 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 respor}sibil' y for all work done by either myself, my agent, servant or employee.
CON OR Bl7ILDER BY AUTHORITY
)UILD
ING
LECTRI
PLUMBING
Owner of
Building
Architect
Contractor ,{ 1 IP E
or Builder
Legal Lot Bl.
/ 7
9 Description f �'°�� � �
Address of �-'
Building / x
This perm t is granted to the contractor or builder named above to construct the building or to install the equipment or device . escribed in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. 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 authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assysnes the Cspons•kiility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or f'wmgsjo in the,Ateiptilts or specifications and that he assumes respon-
RIN
sibility for work done by his agents, servants or employees. / f f " `� : '`""
g Cf. '`��P� a� ;f By
Si ned � _ IPQS PEOTOR B
In consideration of the issuance to me of this permit I agree to perform thew rk coveiereunder in compliance with dinances and guiations
pertaining thereto and in strict conformity with the plans, drawings, statements or specific�ations submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume respo sibity for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR
MIAMI SHORES VILLAGE, FLORIDA
DATE 3,
ERMIT N° 5220
Work to be performed under this Permit
Value of
Project
Subdi I
vision
Contractor's
License No.
Amt. of ' Noe *
Permit 8
AUTHORITY
19