PAINT PERMITSPROPERTY OWNER
New Construction
Enclosure
)
Name Scc1 Qt �.hQ.M1yi mmat/am
Address I . /E (OV St",
,v
ml e, 4I shores '2. 3 3 /3S'
Home Telephone 3 75s 5(/
Repair
Business Telephone-304- 7 5 7 y 7_3
S
Demolish
Fax '-.; n c - 7 f. ez3A
Shell Only
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which frfhs ;besigs d. by the p.oj erty o wner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate procesqn gttlfyodr 41)pQratioo. If roofing work will be done, a roofing application must be submit-
ted along with this permit application. • • • • • • • ;.. ••. • •• • • • •
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
A!'PLICATION
Job Address: 1 3 U / V E
Address
Folio Number
Lot Block
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
• • •• •
• • • •
• • • • • • ii, • • • • •• •
• •
• •••••••
•
••
• •
•
•
.. •
ARCHITECT
Name
License No.
Address
Telephone
Fax
•
• •
• •
• •••
.. JVlaster Aatinit No.
• iSpbsitliary Permit No.
• . • • • •
' 03
D O S'fi /�'l (,,✓), 1 5 F 3 3 G 3 8"
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
Apt. City
escription of Work
p a,1 ntI.y
State
PERMIT APPLICATION
Zip
Subdivision PB PG Zoning Linear Feet
Current Use of Property Sr ugre Units Floors
Proposed Use of Property etltie of Work 2-2_00 Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
..•
• .• • •
Page 2
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• •
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•••••••
• •
•
•
•
PERMIT APPLICATION
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING AReE1 / t YO118 VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED NJ•A CLUAN, 4,I EAIAVD,VN1TARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL B€ KEIEI:FICEty'FI;O1 I E 1 AN�DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAN4AGED 40QIPPE:sIT:0 t VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk. • • ••• • • • • • • •
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, Is' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STA OF FLO DA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
ig gnature of Owner h Signature of Contractor / Qualifier
t 5 -& I
Print Name
S om to and subscribed before me thi day of
gnature of N if . ry Public State of I
Angela
SEAL: •; My Comm:.'• DD150048
%a " Expires November 15, 2008
Personally known OR, Produced Identification
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
Personally known OR, Produced Identification
Type of Identification ProducedLL )L f\ A 6 - 1-.. a, Type of Identification Produced:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 2/7 /2003
Applicant: X C
Owner:
JOB ADDRESS: 134 NE 100 ST
Contractor
Local Phone:
Parcel # 1132060132150
Fees: Description Amount
FEE2003 -846 Building Permit Application Fee $60.00
FEE2003 -847 CCF $1.80
FEE2003 -848 Notary Fee $5.00
Total Fees: $66.80
Total Fees: $66.80
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 8/6/2003 Construction Value: $2,200.00
Work: EXTERIOR PAINTING AS PER AGREEMENT
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
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:
Building Permit
Permit Number: BP2003 -219
Contractor's Address:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 10 & E1/2 LOT 11 BLK 16 LOT SIZE
Signed (INSPECTOR) BY:
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 responisibility for all work done by either
myself, my agent, servants or employes.
REG COI 021203 1502 MC#01 004000 CHARGE .,0
(Contractor or Builder) BY:
' f o .� ••• •...
ATE: '2- .. •
.. . .. •
e9WNER'S NAME: Sc i- -v- C11e •I kk (1il 1,PHONE: 3o5 '5r34�1 /
1ADDRESS: i3 /■A � E ' / 5r, i m j , u r, s - Ft._ 33I f
** 1 * * * * * * * * * * * * * * * * * * ** *011 *�. * *it ** * * * * * * * * * * * * * * * * * * * * * * **
DRESS OF SITE: 13 lv :l e i.: •
.
CONTRACTOR & LICENSE (if applicable) f
COMPANY NAME: / PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be lis ed and indicate the
Walls Ct e 5- lees -j'o, iv i
Fasciadt,�(o' (oaq eor /ten r ( .�
c ", Ir'
rip Cap/Drip Edge v/
offit Y1 /R
oof
lower Bins
Shutters
Awnings
Chimney
MIAMI SHQRES.VILLAGE
Paint irid Agreement
Doors and door jams Ph, (4.0e -(pb la- C rec.-0
Garage Doors 14 )4.
Railings 9e or
ences
ecorative
n ( k
etal r1/4. tat-k•
All brick (simulated or regular) err
Stucco Banding /q-
Any other stucco features (decor PA) la,(p 1 kit (rea- 4
Accessory Buildings n 4 and eory,at h 6 reati
Other G'ilnp ow 1�, I a 42 to h i a. C(�e
(v (Ni rid o:J Lc dles . _ or 1.4M le
OWNER'S AFFIDAVIT: I certify that all the re i formation is accurate
and that all work will be done in compliance with all applicable laws regulating
construction and zoning. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will be as per the attached
sami}es.
APPROVED:
3uilding Of d ial
frtj A-
1/ I a—
in I A.
C chu,k y C f
.)-, G o3
ate
color to be painted.
t-( °
N , S Totic nOL °/ZS
0
\ r
0
Chestertown Buff HC -9
Philadelphia Cream HC -30
Ckk
ignature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Georgian Green HC -115
4/23/01
ELECTRICAL
'1'YI'E
Minimum Fee
QTY.
TYPE
Dryer _ • •
0T7.
•
"FY N% ;
patl &Appliance
QTY.
TYPE
Service Repair
Q'I'1'.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16 -20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
.Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
QTY.
'I'YI'E
Condensate Drain
QTY.
TYPE
Generator
QTY.
TYPE
Refrigeration, Tons
QTY.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPE
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
• • • • • •
• • • ••• •
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• •
• •
• •••
••• • •••
• • •
• • •
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of Bork being pijfornte,P and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DA TE
/A /
Zoning
QQ
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
`�
/
Building Official
'd"
Page 4
OFFICE USE ONLY
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
Notary
•
• • •
•
••• •
• •
•
• •.
.•
•
• • •
❑ PROOF OF OWNERSHIP • • •
(Attach
•. .. •• • • • ••
• ❑ HRS / DERjvI:eYPP40FAF :. •
(Sepfic7'StvOer, ••• • . •••
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ 'o
$5,o
. .
• • • •
• • • • • .
• • • • . .
• • ... . •
•
x ¢ 60) x/1000
(¢.005 / sq.ft.)
(0.01 /sq.ft.)
PERMIT APPLICATION
CHECKLIST
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $ ,3r)
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 1 3 q7 Job Address 134 1•1 (DO Tax Folio
Legal Description Historically Designated: Yes No ✓
,STATG
?wne�Lessee / Tenant ,AR /1f/ 4//'E ^i D T Master Permit # 07/'41
Owner's Address 3 V/ _De__ 4. et, 0 l7' . "f . $ • 3 / 6 ' b Phone 1 - O 6 95
Contracting Co. t irnt -(it,/ Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 4a-4A/
Square Ft. Estimated Cost (value) Y'
Signature of owner and/or Condo President Date Si a ure of Contractor o Owner -Build
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.
OWNER'S AFFIDAVIT: 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.
l-13�ti�
Date
t -0 -5c.
Notary as to Owner,and/or Condo President Date Notary as to Contractor or Owner- Builder Date
My Commission Expires: My Commission Expies;---::....<..,,.x,:,:, ,,,...,, .,. -.,,rs
, P OFFICIAL i'iOTAi i SEAL
2 , r; <- SCOTT W DAVIS
- c S; * COMMISSION NUMBER
CC255237
co
r,(<, 4` ci MY COMMISSION EXP.
OF FL -MN 2.5 1997
FEES: PERMIT RADON C.C.F. NOTARY 5"00 BOND
TOTAL DUE %
APPROVED:
Zoning Building I I Electrical
Mechanical Plumbing Engineering
Date '/ 9/ b Job Address
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
l 3 /1/ D 5- i • 1'ax Folio
Legal Description Q / Historically Designated: Yes No
2
Owner/Lessee / Tenant < / Hie ../) T L .
Owner's Address � C Phone
Contracting Co. (9C.e -- / Address
Qualifier SS#
State # Municipal # Competen
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION J/ C/" f2(
Square Ft. Estimated Cost (value) 4 0
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
RADON
APPROVED:
Zoning Building
Mechanical
C.C.F. ; S
Ei
NOTARY
Master Permit # j6 -g 3 / J
3- o �9SQ/� �
4
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YO . AILURE TO DO 0 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.
OWNER'S AFFIDAVIT: 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.
Electrical
Notary as to Contractor or Owner - Builder
My Commission Expires:
NOTARY' SEAL
SCt ; T W DAVIS
COMMISSION NUMBER
CC255237
MY COMMISSION EXP.
TOTAL DUE 1.$
Plumbing Engineering
Date / 6 M
Legal Description/ /6
Owner / Lessee / Tenant
SARA RE NwT Master Permit 4` f ` - d , �
Owner's Address � tJ T lOOST .
Contracting Co.
Qualifier
State # Municipal #
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
RK DESCRIPTION POUSE - PA Jf E
Square Ft. Estimated Cost(value) Xe O 0, 60
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.
OWNER'S AFFIDAVIT: 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.
0
not type or stamp name of
Signat �� 4rner and
Date: // ::+L
JOSEPHINE CHURCH
a ; . a .,; A3n Exp. April 30, I
/ No. CC197545
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 134 N� (OO ST.
•,..:�%!..W i /.✓.f
( p�.n ' io t :
N ary as to Owner and /4 ersoV an, 4
um e � .
My Commission Expires: ib r o
,
❑ DID take an oath /or
01 DID NOT take an oath.
* * * * * *
** *
APPROVED:
•
Zoning
Mechanical
SS# - -
Competency # Ins.Co.
Fire
londa
Norar Public
uced LD.
produced:
FEES: PERMIT 37` 5 U RADON C.C.F. r5
Buildi
Plumbing_
9 11cZ,vi
Address
Tax Folio /✓ .32dt /3 115 -/
Phone
Phone
Signature of Contractor or Owner- Builder
Date:
Notary as to Contractor or Owner- Builder
My Commission Expires:
* * * * * * **
NOTARY 5 TOTAL DUE 1 /9/Pe
Other
.4/ Electrical
Engineering
ti
,57,2 5
BUILDING
LECTRICAL
P LUMBING
Owner of
Building
Architect
Contractor
3r Builder
Legal
1)escription
Lot
CONTRACTOR OR BUILDER
. MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? = 4162
Work to be performed under this Permit
Bl.
Subdi-
vision
DATE 194 t --
Contractor's
License No.
7
Address of ' ~'` 0- Value of Arnt. of
wilding i > Project .,j .,° Permit y ,r'
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 appli-
,ation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any
Glans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
;t 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
. egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. . `! _, ,,�
Signed '...,r • �:
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 pe nit I assume ,responsibility for all work done by either myself, my agent, servant or employee.
d
� / ' r r
. ,
BY AUTHORITY