PAINTBUILDING ❑
ELECTRICAL ❑
PLUMBING ❑
HOOFING ❑
❑
Owner of
Building f r•,•,r�'/:�!.v,�
Contractor
Dr Builder
Legal Lot
Description
MIAMI SHORES VILLAGE. FLORIDA
DATE // 1 d 195
CONTRACTOR OR BUILDER
PERMIT N? 6163
Architect
re
Address of /�'
wilding f' ` c .. .
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project $
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
ierefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans
lrawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This. Permit may be revoked at any
ime 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
;ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
3ertaining to the work covered hereby whether shown on the plans or drawing r in the tatements.or specifications and that he assumes responsibility for work
lone by his agents, servants or employees.».
INSPECTOR
BY
Contractor's
License No.
Amount of r ," ' ?
Permit $
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
'ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
epting this permit I assume resposility for all work done by either, myself „my agent, servant or employee.
L it l ; J' j ; ;2 j.
AUTHORITY
6 s�a
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Z-2 6C1 Job Address 6 60 /1/6 57S 1 5 Tax Folio
Legal Description 7 Historically Designated: Yes No
i� /
Owner/Lessee / Tenant C A . / 9/'i°s Master Permit # 7 30
Owners Address CC 0 NE $ 5 T Phone
Contracting Co. (7 C4_)/1 Q r Address
Qualifier ' e
State #
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle on
WORK DESCRIPTION
Municipal # Competency # Ins. Co.
LECTRICAL PLUMBING MECHANNICAL ROOFING PAVING FENCE SIGN
GI / 6't T � 2` / i' 1, r /'/)-Yj
Square Ft. Estimated Cost (value) vr7 L5
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNERS AP'F'll)AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Notary as to Owner and/or C : do President Date
My Commission Expires:
FEES: PERMIT
RADON
C.C.F.
Building qlfS �✓+ ��
ss# . Phone ..3 r 7r 7_0 //y
WALL
Notary as to Contractor or Owner- Builder
My Commission '✓ � i" t p ��go{�FJ�FlyciAAL ► NOT ARSSe
.. - OO: NU
ro �
Q ��B e�,y „�pNU33lON EXPIRES
NOTARY BOND
Electrical
TOTAL DUE
) Zr
Date
Date
APPROVED:
Zoning
Mechanical Plumbing Structural Engineer