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BUILDINGMIAMI SHORES VILLAGE, FLORIDA w. BUILDING ❑ DATE eta. 195 ELECTRICAL ❑ PERMIT IT? 12609 Contractor's ,y �»� PLUMBING ❑ License No. ` ROOFING ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER 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 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. Signed• 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. 5;, 4. Amt. of Permit $ BY AUTHORITY I1 PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER Simms Silberman 1 -9-52 ADDRESS 122 N.E. 101st St. LEGAL lots 11 -12 bl.15 Sec.l Application is hereby made for the approval 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 s1 CI 113 • , . ` Owner's Name and Address KI?,S . E t1\{ ______ 1 J. C 1 1��� N S Street_ 1 W , k . Registered Architect and /or Engineer � a 3 SZ� 1 Tr- Name and address of licensed contractor J ©l, N Sc ::+ Al C q -(l Location and legal description of lot to be built on: Lot ‘1 - t2 m Block 1 Subdivision_ C LkII2CS C€ C_ . Yr vl..2 +, 10 ss ST. Street and Number where work is to be done MIAMI SHORES BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT State work to be done and purpose of building (by floors) - _ i C� d _� _4 ����_______ r _s ►_�.`�________ . c� � t � E+ and for no other purpose. New Building V Remodeling Addition Repairs No. of Stories OtAC To be constructed of___ � • Kind of foundation__ ] _ t �03 c, Roof Covering____ 1_ p Estimated Total cost of improvements $ l3 o 0 L o C O° j ___ _ __Amount of Permit $ Zone cubage required _____.__«,SOO C _Plan Cubage (1 y Distance to next nearest building Z. 4.V -- Size of Building Lot COQ X I . (.cD 1. Maximum live load to be borne by each floor I hereby submit all the plans and szcifications for said building. All notices with reference to the building and its construction may be sent to O40,00.3 k S.11_e r \O' IM,E 1 `fit-` Sf. • 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 wgrk to be performed under .this permit, as are licensed by Miami Shores Village. Remarks____ (Signed) C� 0" Notary Public, State of Florida ui ding Inspector My Commission Expires ,19.S172. i�h �-f STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared - - 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 (�� v Date ( 5' J 1 ' Read, Sworn to and Subscribed before me. Disapproved Date (Signed) PLANNING 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. BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of 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 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done / State work to be do and purpose of building (by floors) ( p . and for no other purpose. New Building .. - _ . Remodeling___. Addition ............. ..... ..__._ Repairs.._ ..... __ . _ _... No. of Stories To be constructed of Kind of und n Roof C vering__ Estimated T ;tal cost of improvements $ � Amount of Permit $ Zone cubage required _Plan Cubage 2_Z-,1 Z. Size of Building Lot Distance to next nearest building STATE OF FLORIDA, COUNTY OF DADE. Permit No Disapproved (Signed) The undersigned applicant for this building permit does hereby certify ;hat he understands an of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gener and has complied with the rovisions thereof, and will require similar compliance from all co in the work to be performed under this permit; and will post or cause to be posted for inspec or notices as are required by the Act. The undersigned agrees to employ only such subs n ' permit., as are licensed Miami Shores Village. Remarks__ ss. MIAMI SHORES VILLAGE Date ° ©�e2 oS (Signed). X PLANNING BOARD DATE No Street 0/ o 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 he sent to the build - of Miami rules and approved 19 and its construction may accepts his obligations as an employer rFlorida, Permanent Supplement, 0j/sub-contractors employed by him site of the work such public notice work to be performed under this Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ep- peared and who, being by me first duly sworn, upon oath deposes and says that tie is the- - -- . -.. - of the abov:• de.cribed construction, that he has carefully read the fore: :ing application, and that he did sign the same; and that all facts therein by him stated are trt e. �( �- �� Date „ . Read, Sworn to and Subscribed before me. I Public, r „� No± r ay , State of Florida y ��, �il.i g�,�� spector My Commission Expires_ to me well known, Chairman / Member Member Member Member Member Council Approved __ ________ __ ______ ..Date Disapproved .- Date NOTE: A charge of $1.00 will be made for making corrections on 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.