Permit docs 1967BUILDING ❑ MIAMI SHORES VILLAGE FLORIDA -
Date
ELECTRICAL 0
PLUMBING ❑ PERMIT N° 8699
ROOFING ❑
Owner of
Building
CONTRACTOR or BUILDER
Work to be
t )/
Architect
or Builde , 4 • ri r l A :
or Builder `--
Legal Lat 11 71
Description (I BI
Address of � ° C
Building Al /` f
performed under this Permit
Subdi-
vision
Sq Ft
Value of
Project
BY
$
1947
Contractor's te, 5 r V
License No
�•, T4.0 "J 7
f I Amount of ,?
Permit $ .� " p
;, 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 applica-
- i`ion 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 ass,nmes the responsibility for a thoroueh knowle o the ordinances and
regulations pertaining to the work covered hereby whether hown on the plans or drawings or in the statements or specifications d tha he assumes respon-
sibility for work done by his agents, servants employe ..
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Signed "' f - 14:44,..... t : NBPECTOR) BY �'"
In consideration of the issuance to me of this permit I agree erform the work covered hereunder in compli with all ordinances and regulations Mires pertaining thereto and in strict conformity with the plans, drawing s Cements or specifications submitted to the prop Authorities of Miami Village.
In accepting this permit I assume responsibility for all work do either, myself, my agent, servant or employee.
AUTHORITY
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 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 not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address._. _ /__1.1.5 ._.(__/�'_U` `
Registered Architect and /or Engineer... _
Name and address of licensed contractor.. e /r 4
Location and egal description of lot to be built on:
Lot.. Block. ___) . 7_______ ___ __ Subdivision
Street and Number where work is to be done / Q
State work to be done and purpose of building (by floors)
(Signed)
Chairman _
Member
Member -
Council Approved
0
Building Inspector
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
MIAMI SHORES VILLAGE
._Date
4
(Signe
Date
47/7 .C./
MkCommission Expires__
No—. /0 do Street
7oKe
, l am
DATE
Member
Member .
Member ..-
Disapproved
7e
,19
and for no other purpose.
New Building R modeling Addition /( Repairs No. of Stories
To be constructed of_�_/Ye & _. Kind of foundation Roof Covering.__
Amount of Permit $ S,
_Plan Cubage
Size of Building Lot
Estimated Total cost of improvements $
Zone cubage required
Distance to next nearest building__
Maximum live load to be borne by each floor_._
I hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit doe hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen s Compensation Act, being Sec; ion 5966, Compiled General Laws of Florida, Pennanent 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 fore spection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such ss. ontractors, on work be performed tynder is
permit, as are licensed by Miami Shores Village.
Remarks
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 has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
�__ � � Date..
Permit No
Disapproved ____ _ '�_ __. �I
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
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