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STATE OIL` FLORIDA) Sg
COUNTY OF DAD?
And Further thid Deponent nays not
X ¢W /....._._. of the Village of Miami Shores,
County of Dade and State of Florida , being duly sworn, doth depose and say,
that under the provisions of Ordinance Igo, 185, dated June 15, 194 amend-
ing paragraph (d) of Section B-363 of Ordinance Uo. 97 of the Building Code
Of Miami Shores Village, he desires to build a 41),,r 1Qz.._., itax� l Estd4.4cte.
OA L t /.. k �k...a...B1ock ._ . o£' &... ;..� lit . . _,SuUdivision,
that he is the owner of said property, and will be the owner of acid
. �_ _ , that he will de the Mork personally,
and that he will, at such tired e.s are required by the Zoning and Building,
Director : --
1. File plans and specifications and obtain approval of the
Planing Board and the Building Inspector.
2. Apply for and secure a Permit.
3. Pay tho required fees.
4. Jxecute the work in accordance with the provisions of this
Code.
5. Apply for inspections.
6. File with the Building Inspector certificates that provision
h.o been made to carry the necessary Workmen's Compensation,
Pub1io Liability and Property Damage Insurance.
7. File with the Building Inspector as the 4ob progresses certi --
ficateo showing the payment required by the Federal Social
Security Aot to the:State of Florida or the United States of
America.
$. Assume the responsibility of not employing other than properly
licensed contractors by Miami Shores Village for any part or
portion of the work
9. Not set himself up as a «contractor ".
10. Sign an affidavit before commencing work to the effect that
he has read this Article and will do the work personally and
observe 411 of the requirements of the Building, Electrical,
Plumbing and Zonngi Codes of Miami Shores Village. Such
affidavit to be properly notarized upon blanks to be supplied
by the Building Inspector.
11. In order to prevent abuses and subterfuge the right of ouch
owner- builder ad herein provided, is limited to but one
owner - builder permit each 2 years, and where an owner - builder
has once exercised the privilege herein conferred no second
application for other- builder permit shall be granted in less
than 2 years, unless the applicant io qualified as A licensed
General Contractor Under tho applicable Ordinances of said
Village.
OWNER
SUBSORIBE0 AND St-WORN TO 040R3 MC. this ' day of A. D.,
NOTARY PUB
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