285 NE 98 St.A41,
APPLIC
1kA.,
Ti
FOR
Application is hereby made for the approval of the deL iled staternen of the plans and specifications herewith submitted for the build-
ing or o h r structure her i described. This rjlicatlo , is made in compliance and con.ovm.ty w the Building Ordinance of Miami
Shores Village, for da, and all pro. isions of the Laws f the State of F krid. all o dmances uf Mi au Shores Village and all rules and
regulaiions of the Building Div i of ..iam Slic4 illage h '1 ,e o iphed with, whether herein specified or not. A copy ot approved
plans and specificati n must be key at building durin progress of the wcrk.
Date 4/-
Owner' Name and Address - No. Street_
Registered Architect and/or Engineer.
Name Ind 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 OF FLORIDA,
COUNTY OF DADE. Ss '
Chairman
Member _
Member _ . _
Council Approved ....__
MI SHORES VILLAGE
BUILDIN INSPECTION DEPARTMEN
UILDING PEFRMIT
Subdivision
g '
PLANNING BOARD
Member
Member
Member
_Date Disapproved _
DATE
State work to done and PurnPsejuildin g (by floors).
and for no other purpose.
New Building_ Remodeling_ Addition_ Repairs_ No. of Stories.
To be constructed of_ _ Kind of foundation Roof Cov
/ 6
Estimated ' Dtal cost of improvements $_. —. Amount of Permit $_
Zone cubage required_ _. Cubage
Distance to next nearest building_ _ _ _Size of Building Lot
Maximum live load to he borne by each floor_
hereby submit all the plans and speciiications for said building. All notices with reference to the building and its construction may
be sent to
........... --•
The uncle signed appli .ant for th;s building permit does hereby certify that he understands and accepts his ..bligations as an employer
of 1; bor under he Florida Workmen's Compensation Act being Siotion 5966. Col pled Gen al Laws of Florida P. r anen. Supple nent.
and has complied with the provkions thereof, and will require similar compliance from all contractors or sub-contractors emplo-ed by him
in the work to be p..rfr.rmed under this permit. and ill post or cause to be posted for inspection on the site of the work su.:h public noti-e
or r.otit es as are required by the Act. The u..dur ign..d agrees to employ only such abcontr ctors, on work to be perform . der this
permit as are licensed by Miami Shores ihage.
Remarks_ (Signed).-
Before me, the undersigned authority, a notary public, duly authorized to adm.nister oaths ,.nd take acknowledgments, personally pp-
peared
to me well known,
and who, being by me first di sworn, upon oath deposes and says that he is the
of tit abov. de,ci ibed Instruction , t 11:- has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are tr ie.
Permit No./ 0.0 Read, Sworn to and Subscribed before me.
Disapproved
Date._
( Signed) ____
Building Inspector My Com:nission Expires.
Notary Public State of Florida
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application Iftcr approval his been obtained from
the Planr:ng Board
A re•inspection fee of $1.00 will be charged when such re-inspection is made necessary by improper notice for inspel.t•on or fa. Ity
materials and/or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
PERMIT N9 2844
❑
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA,
Work to be performed under this Permit
B1
Signed.
Subdi-
vision
Value of
Project $
DATE
Contractor's
License No
Arnount of
Permit $
BY AUTHORITY
195
This permit is granted to the contractor or builder named above to construc 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.
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 regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.