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260 NE 99 St (9)BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Lot Bl. Description Address of Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 3630 Work to be performed under this Permit ..� , tilts „�1- �i:317 il%f� Ii:: tt, ...' 6-131c n_ 'nu LintsTi Oti4 1ka: i'tOUlr■'!Orr koi:rd Oi :^2 befcre star; ng the wirk author zed in this ptsltllit. Subdi- vision Value of Project DATE 194— Contractor's License No. Amt. of Permit 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, servants or employees. Signed. By 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 regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Sharer Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. F 2 . Li CONTRACTOR OR BUILDER BY AUTHORITY 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 building 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 regula- tions of the Building Division of Miami Shores Village shall be complied with, whether herein specified o not. A copy of approved plans and specifications must be kept at building during progress of the work. / - D ate_ �_ -- ___ -- � - .� - -_- , 19_—__. Owner's Name and Address f--- Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block- — �_r_ Subdivision Street and Number where work is to be done 0 I COI 4 State work to be done and purpose of building (by floors) __ Building Inspector My Commission Expires_ Street_.._______ Roof Covering Estimated Total cost of improvements of Permit $ • • __and for no other purpose. New Building_ Remodeling __ Addition Repairs No. of Stories________________ To be constructed of___________________ Kind of foundation 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 the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. f Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. Permit No._____ _ __ ___ ___ _ Date___ Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) PLANNING 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 been 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. Owner's Name and Address STATE OF FLORIDA, ss. COUNTY OF DADE. (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT,7 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 regula- tions of the Building Division of Miami Shores Village shall be complied with, whether herein sprified "qr not. A copy of approved plans and specifications must be kept at building during progress of the work. .. ., No—__________ Street_____ Registered Architect and/or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot_ Block____ Street and Number where work is to be done State work to be done and purpose of building (by floors) New Building_ _______ Remodeling Addition_ To be constructed of________ Kind of foundation ./1 and for no other purpose. Repairs No. of Stories_________ Roof Covering________ _____ Estimated Total cost of improvements ____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 the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon_ tractors, on work to be performed under this . ,, ..., ... permit, as are licensed by Miami Shores Village. 4. 0/ 1 I , '- d 1 Remarks (Signed) ''' - - ., i ..'' — — 1. .,o___t_ Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. Permit No. Date_ Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida Building Inspector My Commission Expires__ zJtJ s — 1 PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been 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.