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565 NE 101 St (13)1BUILDING L ELECTRICAL PLUMBING Owner of i Building N. #V 4 Architect f Contractor or Builder w4" N _ f MIAMI SHORES VILLAGE, FLORIDA El PERMIT N? 5258 Work to be performed under this Permit r i t ' ' = t DATE Contractor's License No. 194_ a '-p S Legal Lot Description Address of e r Value of Amt. of ' rd Building ,•. i ` Proje .A� s Permit ' . •.- '.. This permit is granted to the contractor or builder named above to construct the .'Aiding or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w'th the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved 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 withoup authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above ass s t he r9sponsiVity for ,a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or ngs7P,intthhe statements for specifications and -that he assuthes respon- sibility for work done by his agents, servants or employees. Bl. Subdi- vision • CONTRACTOR OR BUILDER Signed. --if 1:. '` By y In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and reations pertaining thereto and in strict conformity with the plans, drawings, statements or specificafions submitted to the proper authd i of Miami Shite.s5r1Wece. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building 4 In consideration of pertaining thereto and nx In a' e.Ling this pe 4i MIAMI • SHORES VILLAGE, PERMIT N2 5258 Contractor's License No Work to be performed under this Permit 4,9 e / os. is. c) k Architect Contractor or Builder Legal Lo Deserr ption Address of Building This permit is granted to t contractor or builder named above to construct the .0 • cation herefor in strict compliance with all ordinances pertaining thereto and with the unclerStal plans, drawings, statements' or specifications that may have been submitted to and approved gy at any time if the work is riot done in compliance with such ordinances or if the plans are change perm4 is granted is jtbe understanding that the contractor or builder named above as regut (ions pertaining to .t e k covered hereby whether shown on pla sibility for work done by hits a servants or employees. BL the isukiee to me of this permit T agree to gnr tact conformity with the .plants, clraVOhngs stai assn xbe responsibility far all work done by Signed - Subdi- vision 'RI DA DATE to install the equi$n ,....0-1- "i e appli- r'g that the work twill be performed in compliance with any • e proper municipal authoress This permit may be. revoked 41 withott uthorization. A further conditio upon which this opstb a thoro.ugh knowledge of ,_e or.:naae and r spe sections and s Xespon- tt "the wt ,'_ eon r . d -r in compliance with all ordinances and regulations ven br speoii'•ieajaoa , sdbrnitted to the proper authorities of Miami Shores Village. rnyielf, my agent, servant or employee. AUTHOlUITY 194--- t 1004 APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the buildin 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 regula- tions 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. �� t A 7,„/_<._ /�- Date_ -- C______ -_ -, 19____. Owner's Name and Address r �' /.r'� __lam _ .it-e !—� No._______ _ _ Street_______ Registered Architect and /or Engineer /� �] Name and address of licensed contractor 041/ dX I d/,PS Location and legal description of lot to be built on: Lot T Block_ Subdivision Street aid Number where work is to be done $C' ea 4/07 ' 2 State wor to be done and purpose of building (by floors) c-/ 6 /N70 4,4" Q f L LI ,7111,/ ,9ei ____________ and for no other purpose. New Building______________ — __ �_ Remodeling_.. Addition__ Repairs No. of Stories_____ To be constructed of________________ Kind of foundation ________________________� Roo Covering Estimated Total cost of improvements $_ _74____..___.__A of Permit $ Zone cubage required____ Plan Cubage Distance to next nearest building__ —_ w__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, 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 under this permit, as are licensed by Miami Shores Village. � D ' , �/ Remarks (Signed) STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take k nowledgments, personally appeared (Sighed) 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 s are trrue le ) Permit No r • Date___ \ \t j 4...1 c Read, Sworn to and Subscribed before me. Disapproved _________________ Date Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Notary Public, State of Florida My Commission Expires • to me well known, 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.