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431 NE 100 St (9)BUILDING [J ELECTRICAL. ❑ PLUMBING ❑ ROOFING ❑ d� ❑ Owner of Building Architect Contractor ' or Builder Description :Lot • fi, • CONTR.4CTCR OR BUILDER MIAMI SHORES VILAGE. FLORIDA PERMIT N° Address of e 3 "� ° • B1 "- ,AAIT ti � �t f ? 195 Cbit s LIkef LTo. Work to be performed under this Permit Value of Project $ Subdi- vision Amount of ? Permit $ �- This permit is grated 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 cr specifications that may have been submitted to and approved by the proper municipal authok es. 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 unde:rstanding that the contractor or builder named above assumes the responsibility for a thorough knowlea - 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 • assumes responsibility for work done by his agents, servants or employees. Signed- ' T , BY. ,'" INSPECTOR i/ In consideraticp of the issurfnce to me of this permit I agree to perform the work cover* * hereunder in compliance with all ordinances an ciegulations pertaining thereto aF d in stn ct conformity with the plans, drawings; statements or speci cations sb itted to the proper authorities of Miami Shores Village. In ac• cepting this per assum reslionsibilit for all work done by ether, myself, flay a nt, servant or employee. BY AUTHORITY s r f MIAMI SHORES VI BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT be s F - Remarks (Signed) Bu SYz AGE D . Z 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 j— ` 1 7 , 19 Owner's Name and Address.. :T ,,.fl_.g..� �, -lr?..0 £7 34 No 4 ( et /) - (Go S} Registered A rchitect and /or Engineer Name and address of licensed contractor - e_LFa' T C ^t `� ' - � - r i uN � _ 14 7 Z 4 St . Location and legal description of lot to be buiilt on: f 1 (.o y t 1 Block / ° Lot \ Subdivision `lam S 2 / Street and Number where work is to be done ,i3 I Ai 2- 1 0 c' S� State work to be done nd urpose of building (by floors) fNSr_ _'-.I dit.1o. 5. t - 5.... R .4 A -7..o ° MO p_IA_sr- R, �xts,- Zcc1Yg._ - -. A Ar.O.u+t u et R - R‘. , ° tz- '2° E 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 $ Amount of Permit $ z 4 1 4 Zone cubage required _Plan Cubage Distance to next nearest building. Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the pl s and specifications for said building. All notices with reference to the uilding and its construction may sent to f _l�Q_ �.0'� :� ..ofd � sa_e 1 7 N to 71 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 work to be performed unoier this permit, as are licensed by Miami Shores Village. G E (re-7— A ..c T (o • 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 e. Permit No Y7-- Date Read, Sworn to and Subscribed before me. Disapproved Date._ Notary Public, State of Florida (Signed) mg Inspector My Commission Expires NING 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.