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335 NE 101 StMIAMI SHORES VILLAGE, FLORIDA BUILDING ELECTRICAL ❑ PERMIT N9 9409 , LUMBING ❑ OOFING ❑ Iwner of uilding rchitect antractor Builder 'gam Lot II Bl. ascription. ldress of Iilding .,. : ? CONTRACTOR OR BUILDER DATF r ' , Contractor's License No Work to be performed under this Permit _j < 1- • Subdi- vision Sq. Ft Value of Project $ Amt. of Permit $ 195 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 i refor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, c wings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any e 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 u ted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations rtaining 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 ne by his agents, servants or employees. Signed- : r• �.gy INSPECTOR . In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with alF.grdinances and regulations taining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. f BY AUTHORITY MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT 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. Owner's Name and Address._ Imo 4 r • N'......) it 4. L , ✓ .P. No. Street 4 4 CF, /...D./ f �• Registered Architect and /or Engineer /o Name and address of licensed contractor 1 •q • 1 0_ ,C .G FF frA e • / 3 a ' 6 W. _.. 0 .e= ,44‘,/ , Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done e .5 4 C am • / 0 State work to be done and purpose of building (by floors) 6 C q C •E C19: E oK E 4 ..: W. 41 O o w ,I' r ie, Te,/ ,9 p/ Gi9 eAd ad • 7 — Aft r and for no other purpose. rew Building Remodeling. Addition / No. of Stories To he constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ >r.d • Amount of Permit $ S. 0 d 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 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 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 Stif >lement, 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 ' • . ection he site of ork such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such s c on w• to rfo`im under this permit, as are licensed by Miami Shores Village. Remarks (Signed) ' 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 and who, being by me first duly swor , upon oath deposes and - says that he is the of the above described construction, t at he has carefully read the f regoing application, and that he did sign the same, and that all facts therein by him stated are true. IQ ) Permit No 7' C Disapproved (Signed) Notary Public, State of Florida Building In ector My Commission Expires PLANNING BOARD DATE Chairman Member Member Council Approved Date of $1.00 will be made for making corrections OG 7 Date . / r , 19 5 to me well known, Read, Sworn to and Subscribed before me. Member Member Member Disapproved Date or changes to this application after approval has been obtained from NOTE: A charge 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.