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302 NE 100 St (14)BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect contractor or Builder Legal Description Address of _3uilding � - > L Lot MIAMI SHORES VILLIBRI4 ratt,,r ❑ PERMIT 11T° 4313 f' CONTRACTOR OR BUILDER Bl. Work to be performed under this Permit BY • Subdi- vision Value of Project $ Contractor's License No Amount of Permit $ This permit is granted to the contractor or builder named above to construc 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, irawings, 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 , ertaining 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 one 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 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 responsibility for all work done by either, myself, my agent, servant or employee. AUTHORITY APPLICATION FOR BUILDING PERMIT 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 her 'n specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. / Date "'�° � _ �r ! // /' 9 `.. Owner's Name and Addre. No.... D / Street/ STATE OF FLORIDA, COUNTY OF DADE. ss MIAMI SHORES VILLAGE 1 Buil ing Inspector BUILDING INSPECTION DEPARTMENT Roof Covering 7.o Notary Public, State of Florida Registered Architect and /or Engineer Name and address of licensed contractor Location and leg al description of lot to be built on: Lot_ ___4/ 1 / ? Block .4 T Subdivision 3 Street and Number where work is to be done . I ,/r, . g.,._ & 0 il State to be done and purpose of building (by floors) a4 - � `` ✓�0 and for no other purpose. New Building Remodeling Addition._ �� Repairs No. of / To be constructed of. 1.1 1.. / Kind of foundation Estimated Total cost of improvements $ 3 O - Amount of Permit $ Zone cubage req plan Cubage Z S 4 . 3 Distance to next nearest building Size of Building Lot / a 0 X /1 5 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 sent to The undersigned applicant for this building pennit 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 su. ontractors on work to be performed under this pennit, as are licensed by Miami Shores Village. Remarks (Signe• ___ - .ae47 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 4 3 Date f ' � ° Read, Sworn to and Subscribed before me. Disapproved u . (Signed) 7 . ,/ My Commission Expires 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.