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375 NE 99 StBUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Contractor or Builder 4- • - 1 • Address of 3 7 ( •,,) (- Building MIAMI SHORES VILLAGE. FLORIDA DATE /4. 1957_ PERMIT N° 6043 Contractor's License No i2 0 Work to be performed under this Permit Architect 14%J.1), /4 Legal Lot Description 11 Bi This permit is granted to the contractor or builder named above to construc ille 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 suay have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time it the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further conditio �n which this permit is granted is the understanding that the contractor or builder named above assumes the responsibi lor a thorough kn. • r• • of th pertaining to the work covered hereby whether shown on the plans or drawj or in the stet s or specification at he as done by his agents, servants or employees. Signed: BY NSP ECTOR In consideration of the issuance to me of this permit I agree to perform the work cove pertaining thereto and in strict conformity with the plans, doawings, statements or cepting this permit I assume responsibility for all work done e , myself, my 4,4) ( th.• 7 7e,1 SulDdi- vision Amount of 2 Permit $ 00-.0 Value of Z Project $ * CONTRACTOR OR BUILDER AUTHORITY dinemc•s and regulations es responsibility for work / compliance with all ordinances and regulations per authorities of Miami Shores Village. In ac. 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 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 Registered Architect and/or Engineer Name and address of licensed contractor '04/ 4/E Location and legal description of lot to be built on: Lot4' e4 / c2 oQ3 Block IU Subdivisio greet and Number where work is to be done 3 73 / v .S4te work to be done and purpose of building (by floors), state exterior colors (submit samples) ` t!l -lwL�✓ � ` /vV Addition Repairs f To be constructed of Kind of foundation Roof Covering i„ stimated Total cost of improvements S �� © n Amount of Permit S °" Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live Toad to be borne by each floor I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to New Building Remodeling The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 subcontractors 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. 1 ss. 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. P 93 Disapproved Date (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Building Inspector 4 '-' I ' (Y E 9 -.Cr Date Read, Sworn to and Subscribed before me. f - l 19 84` No. ' 73 IVE 9 ' // 57 /5 63l, No of Stories Notary Public, State of Florida and for no other purpose. My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 S25.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and or workmanship.