PAVINGBUILDING
ELECTRICAL
PLUMBING
ROWING
Owner of
Building
Architect
Contractor
or Builder W
MIAMI SHORES VILLAGE. FLORIDA
❑ PERMIT N? 5248
Work to be performed under this Permit ..
Legal Lot ( Subdi
Description 1 I Bl. vision
Address of
@ alue of
Building j • 97 " Sr S r Project
CONTRACTOR OR BUILDER BY
In consideration of the issuance to me of this permit I agree to perform the work co v =d hereunder in compliance
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper autho
cepting this permit I assume responsibility for all work done by either, myself, WY alien#, se or employee.
DATE
Contractor's
License No.
Amount of
Permit $
1. 7'
95 .
This permit is granted to the contractor or builder named above to construct the building or to ia 1 the equipment or device des •.l ®ed applfcation
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with ring " plans
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit nasty he revolced at any
time if the work is not done in compliance with such ordinolicea or if the plans are changed without. authorization. A further condition upo# which this p t is
granted is the understanding that the contractor or builder named above assumes the responsibility for r thorough knowledge of . she prdhaam€es and reguta#s
pertaining to the work covered hereby whether shown on the plans or drawings or in s Ct ie a of •Re «s'. alioay d that he clamors Qasibitt?
done by his agents, servants or employees.
and regulations
fares Village. In ac-
Owner's Name and Address....
Registered Architect and /or Engineer
Name and address of licensed contractor
Disapproved
(Signed)
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 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.
Building Inspe
Ize) e..//
td tv
Location and legal description of lot to be built on:
Lot Block Subdivi
Street and Number where work is to be done ,i[ �fr �. � 7 J.
State work to be Acme and purpose uild' (by fl rs Art
and for no other purpose.
New Building Remodeling. `or"'Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering m$
Estimated Total cost of improvements $ 4 2No- - r . _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 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 th site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontrJsts, ooy gFk Sp be Qerformed under this
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 ar true.
Permit No $2 ' ¥ Date 3 - z-7 a Read, Sworn to and Subscribed before me.
Date_
LANNINC BOARD DATE
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 hecn 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.
C oo 10-#),
Date
No Street
(Signed)
194._?
cale
Notary Public, State of Florida
My Commission Expires
p 7v