1132 NE 101 St (5)• ,
STATE OF FLORIDA) SS
COUNTY OF DADE )
he desires to build
And further this Deponent says not.
w
A FF I7) A. V I T
tate of Florida, being duly sworn, doth depose and says that under the provisions
of Section B .'368, Sub - section (d), of the Building Code of Miami Shores Village
G i on Lot
Block /7 Of 9 0 / : 7 S - 0 - . - subdivision; that he is the owner of said
property, and will do the work personally, and that he will, at such times as are
required by the Zoning and Building Directors -
1. File plans and specifications and obtain approval of Village Planning Board
and of the Building Inspector.
2. Apply for and secure a permit.
3. Pay the required fees for license and for permit.
4. Execute the work in accordance with the provisions of the Zoning, Building,
and Electrical Codes of Miami Shores Village.
5. Apply for inspections.
6. File with the Building Inspector certificates that provision has been made
to carry the necessary Workman's Compensation, Public Liability and iroperty
Damage Insurance.
7. File with the Building Inspector as the job progresses certificates showing
the payment required by the Federal Social Security Act to the State of
Florida or the United States of America.
8. Assume the responsibility of not employing contractors or sub - contractors
other than those properly licensed by Miami Shores Village or any part or
portion of the work including, but not limited to general contracting,
plumbing, heating, electrical, septic tank, solar system, lathing, tile,
torrazo,,painting, jeering and shoot metal work or installation.
9. Not sot himself up as a "Contractor ".
10. Execute Builder's Bond.
SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY of A. D., 19
2 .
1. Signature of Applicant.
2. Signature of Officer administering oath.
a4.1C_of the Village of Miami Shores, County of Dade and