358 NE 101 St (11)MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑ DATF v s,.'t t 4 4 1954_
ELECTRICAL ( PERMIT N? 11787 Contractor's
PLUMBING ❑ License No
ROOFING ❑ Work to be performed under this Permit
Owner of
Building t ‘1 ;`,t , k i,s► i
Architect
Contractor
Or Builder
Legal Lot
Description.
Address of
Building
it) A
Bl.
Subdi-
vision
Value of
Project $
Amt. of
Permit
$ 1
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 a the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted-" and a roved 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 ass es the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans' or drawl s or in the ssa eints or specifications and that he assumes responsibility for work
done by his agents, servants or employees. V ]
SigIIed • \ / J " CTOR 1 � ' BY
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
pertaining thereto and in strict conformity with the plans, drawings, tements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done 'y a ther, myself, my a ent, servant or employee. r
f
CONTRACTOR OR BUILDER
AUTHO
Owner's Name and Address._
State work to be done and purpose of building (by floors)X
STATE OF FLORIDA, i
COUNTY OF .DADE. ss
peared
Disapproved
(Signed)
APPLICATION FOR IUILDING PERMIT
Building Inspector
Chairman
Member ..__.
MIAMI SHORES VILLAGE
PLAN
BUILDING INSPECTION DEPARTMENT
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
Name and address of licensed contractor_ ..41P.att_ -2?
Location and legal description of lot to be built on:
Lot Block '54 �l
Subdivision %- ,,,�
Street and Number where work is to be done 35
. � 1 _� „' -! _.
ate__
,19..1.1
/`4'4,/,x_.. r. , • No
R e g istered Architect and /or Engineer.. .4i ..., . , •._.,, • .,. „ ..................:...::...::.: ,,..,:,,:,,,,:_:,:a:,.,,,_::: ,:,,:,,:,:, ....:.,.-.,.:,
C.;..24CZ7 2457
-- 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 Q Amount of Permit $
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 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, Pennanent 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 t erformed under this
permit, as are licensed by Miami Shores Village.
Remarks..__________________ (Signed)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
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 fo egoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No.___ Date r � Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
NG BOARD DATE
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 hecn obtained from
the Planning Board.
A re-inspection fee of 81.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.