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456 NE 100 St (2)BUILDING ELECTRICAL PLUMBING ROOFING Building /4:11#41 Owner of Architect Contractor or Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE, FLORIDA ----- DATE �� • 1954,,,,, Contractor's License No n PERMIT 'N° 12723 n [� Work to be performed tulder this Permit 56 /(() This permit is granted to the contractor or builder named above to-co stt,��uct the building or to install the equipment or device described in the applica herefor in strict compliance with all ordinances pertaining thereto a d' wit theNnderstanding that the work will be performed in compliance with any plane drawings, statements or specifications that may have been submitted o and approv d by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances ior if the plans are ,changed without authorization. A further condition upon which this permit is granted is the understanding that the con -or..b • namd ab ve assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby,zdhether shown on t e lea or • rawing jet'r in the tatemen ons and that he assumes ;esponsil;ility for work done by his agents, servants or employees. Subdi- vision Value of Project $ INSPECTOR 1 .��►,�ki�?G '-- 0 Amt. of Permit $ c In consideration of the issuance to me of this permit I agree t. perform the work covered hereunder in compl' th all ordinances and regulations pertaining thereto and in strict conformity with the • . drawings, tements or specifications submitted to the proper authorities of Mimi Shores Village. In accepting this permit I assume responsibility for all wor • • •y either, myself, my agent, servant or employee. • c() ITR'ACrOR OR BUILDER BY 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 herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. c - a Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor and legal description of lot to be built on: Lot Block Street and Number where work is to be done Sub State work to be done and purpose of building (by floors)- MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Date No - --- --- Street and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind pf fopppndatio Roof Covering _A Estimated Total cost of improvements $___ ___ mount of Permit $ Zone cubage required ______________ i) lan Cubage Distance to next nearest building ____Size of Building Lot Covering 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 co _ 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 ctio on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub ntract6rs, on work" to be performed undo this permit, as are licensed by Miami Shores Village. _ __ Remarks (Signec0 A / ,1l /:}j . R d 7 STATE OF FLORIDA, ^� , j ,� COUNTY OF DADE. ss' Before me, the undersigned authority, a notary public, duly/authorized to administer oaths and take acknowledgments, personally ap- peared l 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 Date Read, Sworn to and Subscribed before me. Disapproved ___ Date Notary Public, State of Florida ( Signed) Building Inspector 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 resinspection 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. 1JJ:Jrc rlJG h COMJ T/TGUJI VJmJJI ( 21 4 • 11 yawl r.tJCLG• UJ fl'' J11CJ t hcgJJ.Gt cnnv 2,I NJ i.�f..1JJ:J beam, OL TJO Rl rpr rioq 1. o{ J1JJ J pc ?G vifffp Sous E4 1O Pc T4GIA ?1 '1rLGGr ror r oc, / T Oinu0 JtoL'. :Iii U'