375 NE 99 St (14)BUILDING
ELECTRICAL
PLUMBING
OFING
• i / /4
Owner of
Building 4 u I--
Architect
Contractor
or Builder (� "4 fit)
Legal - Lot
Description
Address of la 7 ,J-
Building
This permit is granted to the contractor or builder named above to construct the building or to install the eq
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will
drawings, statements or specifications that may have been submitted to and approved by the proper municipal au
time it the work is not done in compliance with such ordinances or if the plans are changed without authorization. A
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough kno
pertaining to the work covered hereby whether shown on the plans or drawings or in the sf• ements or spec i ' a ' ns
done by his agents, servants or employees.
CONTRA
R OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA /
DATA: qr
PERMIT N? 5599
JA bJt
?+Cf to t , #3/41
95--
Signed:
Work to be performed ender this Permit
P q P14 G PC ei .tic•
t o 0c NL V Si a
Subdi-
vision
Value of i s
Project $
Contractor's
License No.
7
195.
Amount of 2
Permit $
pment or
e performed in
'ties. This Permit
er condition up
e of the ord'
e assum
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work cover -.'' ereunder in compliance with all ordinan
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications ftted to the proper authorities of Miami Sho
cepting this permit I as ►e responsibility for all work done by either, myself, my agent, servant or employee.
rte. 4( 1
BY
described in the application
pliance with any plans
ay be revoked at any
which this permit is
ces and regulations
esponsibility for work
AUTHORITY
and regulations
illage. In ac
STATE OF FLORIDA,
COUNTY OF DADE. j ss •
B uil
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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.
Date �P 3
Owner's Name and Address._... ,P�Ait/ itieki. No.. S.Z Street.!
Registered Architect and /or Engineer
Name and address of licensed contractor «�..,!'� l .�
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done j .[. . J /' • ' E
State work to be done and purpose of building (by floors
7 �'_ �`.�il► Imo ' f /e MO te4. / ° 44614,...01
and for no other purpose.
New Building Remodeling. Addition Repairs No. of Stories
To be constructed of Kind of foundatja, Roof Covering
Estimated Total cost of improvements $ l, sl.._� Amount of Permit $ SP!
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)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he ha carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
.1 /
Permit No._sa� _ te� Fc f j ad, Sworn to and Subscribed before me.
Disapproved
v
(Signed) . ... ..r'
mg Inspector / My Commission Expires
PLA NG 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.
', 4.4✓........, ,t_ `.
J21
Notary Public, State of Florida
7477f,
to me well known,
N
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i