171 NE 100 St (12)BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Work to be performed under this Permit
itt' 4
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 3512
{
Bl
Contractor's
License No.
Subdi-
vision
DATE ft.' le. . 194
7 , �, F -,.!: ° r e _,. :. „a . i , . -,��• ;+ :_.-
WARNING This Construction may be in violations of
Ilia; hooucnon Board General limitations Order 1.41
You are cautioned to consult your War Production
Board office before starting the work authorized in
lbs. pernid.
Address of �, Value of > Amt. of
Building j
/'..I e • i% 4 Its : 4.1A-- Pro —0 U v Permit 4 7 e)
This peI 't is granted to the contractor or builder named above'to construct the building or to install the equipment or device described in the
application he efor rict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance
with any .plans, rawtngs, statement ox_ sp ecifications that may-have been submitted to and approved by the proper municipal authorities. This Permit may
)errevoked at an ime if the work is not Zone in compliance with such ordinances or if the plans are changed without authorization. A further condition
upon which this per it,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
r that he assumes responsibility for work done by his agents, servants or employees.
.r" i
Signed B
t ,INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with r al& i prdinances an rea iJa . pp
tions thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper atlif! rities of MiannS1111% l MS
Village. In accepti, this ( permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Legal Lot Bl.
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE 194 ...,,
PERMIT N9 3512
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Subdi-
vision
Value of
Project
Contractor's
License No.
s may tra in v'rla ''-' rlf
lea; RODUCf►o +► 8uara Ganeral timitat►ons Order 41
You are caut►onrd to consult your war P olaaon
Board office before starting the work authorized in
this permit.
Amt. of
Permit
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 regula-
tions 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.
CONTRACTOR OR BUILDER
BY AUTHORITY
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
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 regula-
tions 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.
Owner's Name and Address UG9 � �� e l Ie No._ I_1_L__ Street__ I e"
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot_____ _ _ ________ Block___— ___ Subdivision 14, S
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
Disapproved Date
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
_JAPPLICATION FOR BUILDING PERMIT
l
t Date_ __ -- - -__ -- • 19
________ ____ _ __and for no other purpose.
New Building __________________________ Remodeling______ __ Addition_________ Repairs No. of Stories____________
To be constructed of Kind of foundation Roof Covering________
Estimated Total cost of improvements $ al-A9 Amount of Permit $
Zone cubage required— ,Plan Cubage -
Distance to next nearest building
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 in ection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcoq actors, on work o be performed under this
permit, as are licensed by Miami Shores Village. I
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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 be did sign the same, and that all facts
therein by him stated are true.
Permit No Date Read, Sworn to and Subscribed before me.
Size of Building Lot
Building Inspector My Commission Expires
Notary Public, State of Florida
to me well known,
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.
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