574 NE 102 St (4)Date �_��®
Type Insp'n T(
Permit No. p env a - /35y
Name
Address 5 n/ � io.P
Company
Phone # C X0.7) 95 - sLo
17 /' °/°/
Inspection Date
Approved
Correction
Re- Insp'n Fee
A
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
4 .
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Owner's Name (Fee Simple Titleholder) 6 4etos Go pa)) Phone #
Owner's Address S14 mg' 1C5.1.ND S r
City t (I4 u.i S lEo2t<.S' State FL
• Tenant/Lessee Name Phone #
Job Address (where the work is being done) 579 Ng I6'2. ND ST
City Miami Shores Village County Miami -Dade
is Building Historically Designated YES NO ✓
Contractor's Company Name tht.pme. cwNEb -- 4e-Lo' C- touc,AtoEs
Contractor's Address S'N-t N E IOZI O Si
City Cr14 tut; Stic2w3
State Certificate or Registration No. a /".
$ Value of Work For this Permit 7oc). °c.
(Continued on opposite side)
Miami Shores Village
Building Department s 14 int ,
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No. �� -- - 1 3 57
Master Permit No.
Electrical Plumbing Mechanical Roofing
Zip 33i3
Zip 3313 8
Phone # yAS 759 . SEY- D
State .FL- Zip '731 8
Qualifier
Certificate of Competency No.
Architect/Engineer's Name (if applicable) 0 I A4 Phone # v/A
ld't.10R-
re Footage Of Work:
Gut'
Type of Work: ['Addition ❑Alteration ❑New [r Repair/Replace ❑ Demolition
Describe Work: ef. c-4-41,3 LINK T�.NGE WAN uOE+- 1eNC t
G A
* * * * * * * * * * * * * * * * * * * *� ** Fee * * * * * * * * * * * * * * * * * * * * * * *>....*
Submittal F e $ Permit Fee $ tc(9 CCF $ el 60 CO /CC
Notary $ _ Training/Education Fee $ of 0 Technology Fee $ g, 50
Scanning $ = Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $ ---
Total Fee Now Due $ ' I lL / 1 .
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the . first inspection rich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
in.spection will not e,apprdved and a reinspection fee will be charged.
Signature, " — i! Signature
Owner or Agent
The f o oin instrument was acknowledged before me this t The foregoing instrument was acknowledged before me this day of 20 G 1 by @ ` t CS 6Z l S. > day of , 20 , by
who is personally know ti me or who has roduced C." . who is personally known to me or who has j_ P Y as produced
As dentification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
.Alll�ttir.�,..
* * * * * * * * * **
NOTARY PUBLIC:
Sign:
Print:
My Commission xpires:
* * * * * * * * * * * * * * * * * * * * * * * * **
* * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc (15/13/03
My Commission Expires:
,ndcu !hn
* * * * * * * * * * * ** ' . * ************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
9
OCT 1820K
Contractor
Plans Examiner
Engineer
Zoning
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
4aos (r)K,Ak E.5
Located at: Sly 0 0 10' ST r HiAta.ti S104245) FC.. 33 tag
Legally described as ,
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the
State of Florida, F.S. 489.103(7),And I have read and understand the following disclosure
Statement, which entitles me td *brk as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction yourself. You may build or
improve a one - family or two-family residence or a farm out - building. You may also build or improve a
commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It
may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is completed, the law will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure
that people employed by you have licenses required by state law and by county or municipal licensing
ordinances. Any person working on your building who is not licensed must work under your supervision
and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction must comply
with all applicable laws, ordinances, building codes and zoning regulations.
Proof of ownership provided ( ) initial of reviewing clerk. The foregoing instrument
Was acknowledged before me this i q day of (fie ,20b(--(
By (0S
Produced
BUILDING DEPARTMENT
being the legal property owner, for the property
DISCLOSURE STATEMENT
3 who is personally known to me or who has
as identification and who did take an oath.
Vargas
sion 4D6 19
: Jul 13,2
nded Thro
Bonding Co , Inc
'Miami Sliore� Vi-teCcce
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, CAZta I AV /98 , does hereby attest that the
(property owner)
attached survey, performed by 1 hO r'i k_.e. 1 L n C
performed on 11 VU I2a01 , is an accurate representation of the existing conditions and
date of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Affiant is
(name of surveyor's company)
Witness(sign and print) Witness(sign and print)
t/Property owner
SWORN TO AND SUBSCRIBED before me this I (4 day of OC.--) '1(
personally known to me, produced CCM 105 C.a 1i1S as identification.
e argas
sion ilDD231984
xpires: Jul 13, 2007
' �'OP rti�P••� on
1 Bonding Co . Inc
Bonded Th ru
5'-O" MAX
Owner's Side
- i1
-II III
I =1 1 . a III
E111 a _I =I1I
1 = 1 1 1 ° a • 111
E 111
I =_I 1 11 =
El 11 =1 I
I III . ° III I - III _ =1 I I
--
Ell' III III
I -1 I I -1 I -1111 11 11= 1 -
- III - III -- III - I I II - III
I III - III - III ^ III — III
-
a
2" X 4" Wa d �a�I
I " X6 "a-I "X6"
Wood Pickets
ete
WOOD FENCES
3I-0"
•
Concurred
2915 Fences
Wood Posts
4' -0" High or Less = 6' -0° O.C.
5' -0' High or Less = 5' -0" O.C.
2915.1 Wood fences, so located on a property
that by zoning regulations they cannot be used
as a wall of a building, shall be constructed to
meet the following minimum specifications.
(a) Fences not exceeding 5 feet in
height shall be constructed to meet
the following minimum
requirements: from nominal 4 inch
by 4 inch by 8 feet -0 inch long
posts spaced 5 fee. -0 inches on
centers, having a fiber stress of
1200 p.s.i. in bending, and shall be
embedded 2 feet -0 inches into a
concrete footing 1 fcot -0 inches in
diameter and 3 feet -0 inches deep. •
Other components shall be
designed to comply with the
provisiops of this Chapter and
Chapter 23.
(b) Fences not exceeding 5 feet and 4
feet in height respectively shall be
constructed as provided in
paragraph 2915.1 (a) herein,
except that the spacing of posts
may be increased to 5 feet -0
inches and 6 feet -0 inches on
centers for these heights.
LEGEND OF SURVEY ABBREVIATIONS
A ARC DISTANCE• AIC ..:. AIR CONDITIONING
C CALCULATED
CL.. CLEAR
ENC ENCROACHMENT
FIP FOUND IRON PIPE
O.H OVER HANG
P.B PLAT BOOK
Pk PROPERTY LINE
UP ... UTILITY POLE
CERTIFY TO:
Carlos A. Guncalves
Terramar Guaranty Title dl Trust, Inc.
First American Title Insurance Co.
Coldwell Banker Mortgage Services, Its
LEGAL DESCRIPTION:
Lot: 3
Block: 94
ADDRESS:
574 NE 102 STREET
MIAMI SHORES, FL 33138
Encroachments Noted:
LOCATION SKETCH
SCALE: N .r S
Subdivision: Amended Plat Of Miami Shores Section No
According to the Plat thereof as recorded in
Plat Book: 15 Page: 14
Public Records of MIAMI -DADE County, Florida. N
M
C.B CATCH BASIN
C/L ....CENTER LINE
P.0 POINT OF CURVATURE
P.O.B POINT OF BEGINNING
W.M WATER METER
M MEASURED
CONC.. CONCRETE
F.0 FOUND
■-! . l02 "1 sr
5
9
n �a
hi.&. 10/ ' sr.
NOTES:
A) All Clearances and /or encroachments shown
hereon are of apparent nature. Fence ownership
by visual means. legal ownership of fences not
determined.
8) Thls survey Is Intended for mortgage or refinance purposes
only exclusively for this use by those to whom It is
certified. This survey b not to be used for construction,
permitting, design, or any other use without written con-
sent of Thomas J. Kelly, Inc.
C) Code restriction and title search are not reflected
on this surrey.
0) The flood Informotion shown hereon does not imply
that the referenced properly will or will not be free
from flooding or damage and does not create Iloblllty
on the part of the firm, any officer or employee thereof,
for any damage that results from reliance on said
information.
E) The lands depleted hereon were surveyed per the
legal description and no claims u to ownership or
matters of title are made or Implied.
F) Underground Encroochmrnts, If any, not located.
I hereby certify that the survey represented
hereon meets the minimum technical stan-
dards set forth by the Bocd of Land Surveyors
in chapter 61617 -6 Florida Administrative Cede
pursue:A to Section 472.027 Flu. Statutes.
JOSE Aj PEREA,.P:. & M. #4858
STATE OF FLORIDA
NOT VALID UNLESS IMPRINTED WITH AN
EMBOSSED SURVEYORS'S SEAL
NOTES:
1. IF SHOWN, BEARING ARE TO AN ASSUMED
MERIDIAN (BY PLAT).
2. IF SHOWN, ELEVATIONS ARE REFERRED N.G.V.D 1929.
3 THIS I5 A BOUNDARY SURVEY.
CBS... CONCRETE BLOCK STRUCTURE
O.U.I OVERHEAD UTILITY LINE
P.C.C POINT OF COMPOUND CURVE
P.O.C POINT OF COMMENCEMENT
BLDG BUILDING
C.H CHORD DISTANCE
D.E DRAINAGE EASEMENT
F.H FIRE HYDRANT
R RADIUS
Successors
50.00 (H)
28.50
/2,2'9
0 2,So'
1C0:9 0
COLIC
0.68
CL
fkla
D N-
0.20 -
Cc
0 0 z
NGVD NATIONAL GEODETIC VERTICAL DATUM
PRC POINT OF REVERSE CURVATURE
RAD RADIAL
RIW ...RIGHT OF WAY
SEC ... SECTION
SCR... SCREENED
S.I.P SET IRON PIPE
SWK SIDEWALK
U.E UTILITY EASEMENT
And /Or Assigns, As Their Interest May Appear
/&2 57:
//
2o 1 , , 15,,0. pavti
Sheet 1 of 1
FLOOD ZONE: X
TH 5 I5 A FLOOD
)>IZARD ZONE
i /THIS I5 NOT A FLOOD
HAZARD ZONE
PANEL NO.:. 93/J
COMMUNITY #: 120652
DATE OF FIRM: 07/17/1995
BASE FLOOD: N/A
FINISH FLOOR: N/A
LOWEST N/A
ADJ GRADE
m
Fif ( 4
/02.35
fC/D.
yJ
B odo
N,^
Zo i-Og
- =owed
rQ
N ib LL
rg
Y
ay'
THOMAS J. KELLY, INC.
L.B. #6486
SURVEYORS - MAPPERS -LAND PLANNERS
333 PALERMO AVENUE CORAL GABLES, FLORIDA 33134
(305) 444 - 7692 DADE (954) 779 - 3288 BRWD
(305) 441- 6494'DADE FAX (954) 779 -3260 BRWD FAX
DATE FIELD WORK
11/14/2001
SCALE 111 - 0
SURVEY NO.
01 -4843
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10 /18/2004
Applicant: CARLOS
Owner: GONCALVES
JOB ADDRESS: 574
Contractor
Local Phone:
Parcel # 1132060171030
NE 102
Legal Description:
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2004 -1357
GONCALVES
CARLOS
ST
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 4/12/2005 Construction Value: $700.00
Work: REPLACED CHAIN LINK FENCE
Page 1 of 1
PB 15 -14 MIAMI SHORES SEC 4 AMD PLAT LOT 3
Fees:
FEE2004 -10198
FEE2004 -10199
FEE2004 -10200
FEE2004 -10201
FEE2004 -10202
FEE2004 -10203
Description
Building Fee
CCF
Notary Fee
Technology Fee
Training and Education Fee
Scanning Fee
Total Fees:
Amount
$100.00
$0.60
$5.00
$2.50
$0.20
$6.00
$114.30
Total Fees: $114.30
Total Receipts: $0.00
OCT 18 PAID
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, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
BLK 94
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date f e - 1 - 31 Job Address 574- /J £ /0 2 St. Tax Folio
.414 oil Alga )1
Legal Description Lof a 8 L It 94- Ste- 4 R Ovietl
Owner/Lessee / Tenant ..-1v 3MJ Pe) ��4/S Master Permit #
Owner's Address 514 1\1 6 tO 2 „c • Phone
C o n t r a c t i n g Co. C I A , 1 e-8. 60
Qualifier (411A/ its • I✓r4�
State # Municipal # 1 2490 Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING � ! M ' MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION S 1'1►C�J h SZ d 8� J3 (ten e e
Square Ft. 130
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Not o O
My Comimssio
Signature of owner and/or Co
do President
er and/or Condo President
Expires:
JOEL BRODER
My Comm Exp. 2 /21IO
Bonded By Service Ins
No. CC534717
1 Pc . pally Known ( l Otb* 1
RADON
0/1 99 -
Date
:: 1417
Date
C.C.F.
Historically Designated: Yes
Estimated Cost (value) 4 7
My mmi
APPROVED:
Zoning Building
Mechanical Plumbing
Address
mature of Contract or Owner- Builder
on or Owner- Builder
on Expires:
Electrical
No
SS# ' Phone 7S7 -b / 6tJ
6-2-
Date
/..a/17
Da
JOEL BRODER
My Comm Exp. 2/21100
Bonded By Service Ins
No. CC534717
Y 13 Personally Known 08
TOTAL DUE=
Engineering
ALHAMBRA CIRCLE - SUITE 404 THOMAS J KELLY , INC.
0 AL GABLES, FLA. 33134
DADE :(3051444 - 7682
BRwO: 1305)779-3268 FAX: (305)441 -8494 LAND SURVEYOR
SURVEY OF LOT BLOCK
SUBDIVISION /1 /e,u/ . - ,1-1 /2E3 .s .crio,IJ 4- 444 /1),
ACCORDING TO THE PLAT THEREOF AS_FREC1rtDED IN PLAT BOOK No. __ /E pT P!1 No...
PUBLIC RECORDS OF DA L.*— COUNTY, FLORIDA. T77 ' E1 ( �7
DATE : FE..6 2.3 I- 1. FOR. , � .34 T� � �f' )�QK/ �../G
LOCATION SKETCH
N ,u
E:1 /02" ST
6 7 c f h
9
n
. kil
o VI
a FL000 .ZONE :
W
ti
19
20
2.1
/t- .. / 0/
1�l
2
22
23
SCALE: I" =A27;5.
24.
1.5
89
)
t� d eP. c, r t ur •,1. 1.10
G !S'W' r r4, c t.
d f x^ a
/M
HAZARD ZONE /20 652
02 t2e/
i ° /J. r'AvA I'T�
10.66
50.ov'(1)
couc. ,Kiv'k: • .
Ad ° I
v
O.10'
FI/' l o.,6o'cc / • 0 0.
7 . / ',a i. P.4u.
A LL
THIS IS A FL000
COMMUNITY PANEL N _
PANEL Ne 07.A SUFFIX
BASE FLOOD ELEV.: did LOWEST FLOOR ELEV. :___��.._......
coJc.
/2 2%
574 . 102"d.c7
A11414/ S -/OkE, g1- 4,
S7;
� .0'
!(0.9 0'
1)
•
SURVEY NO. 2a3
SHEET-1 OF L__
n
N es
4 59
rg 6 0.4
rfiel
7
102.35
1
—(r/Prot c.a.s
J THIS IS NOT A FLOO HAZARD ZONE
DATE OF FIRM: .._. -
HIGHEST ADJ. GRADE : a
NOTE : UNDERGROUND ENCROACHMENTS, IF ANY, NOT LOCATED. 6A/(" , /l.1(?T
1 hereby certify that this sketch of survey of the above described property Is true and correc to the best of my knowledge and
belief as surveyed and platted under my direction. 1 further certify that -this survey meet the minimum requirements adopted by
t Society - Profissional Land Surveyors and the Florida Land Title Association and also CH 21 HH•6 FA. code. There
or no enccc�r'achmton . except as shown.
I. If shown, bearings are to an assumed meridian (by plot )
2. If shown,elevgtions are referred N.G.V. Datum 1929
7 Thl- is o land - .._..
_fifotesslonal Land Surveyor *4555
Closure above I :7500
State of Florida
(Not Valid Unless Imprinted With An Embossed Surveyor'S Seal ) SCALE I": '40
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be byi)t o
Lot Block
Street and Number where work is to be done
State done and purpo�q�q gf buildin (by floors).
Disapproved C'C w ' �` D
(Signed)
MIAMI SHORES VILLAGE
Bui ding Inspe; or
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.
in the work to be performe under this permit; and will post or cause to be posted for inspection on
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors,
permit, as are licensed by Miami Shores Village.
Remarks (Signed).
Notary Public, State of Florida
., 19_LS
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of f undatioo Roof Covering
Estimated Total cost of improvements $ ./ Amount of Permit $ 3_
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, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
d e of the work such public notice
rk o be performed under this
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
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 Z— Date (>� S — C Read, Sworn to and Subscribed before me.
My Commission Expires
ANNING 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.
-71(
BUILDING ❑
ELECTRICAL ❑
PLUMBING ❑
ROOFING ❑
Owner of
Building ✓o is , 4 'fig , f
MIAMI SHORES VILLAGE, FLORIDA �r
DATE
PERMIT
Architect
Contractor
or Builder = --4'
Legal Lot
Description I I Bl.
N9 6512
Contractor's
License No.
Subdi-
vision f l r '7'I i l s
74' 2 -f
Work to be performed under this Permit
trG
194C.
Address of r -- t Value of ° Amount of
Building v '�" 4 Prolect $ 1 Permit $
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 applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with 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 without authorization. A f1rfth.er "Landition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge oNhe ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specificatiN and that he assumes respon-
sibility for work done by his agents, servants or employees. , i t
Signed. i C XIV" - -'‘ /i; it" INSPECTOR
In consideration of the .,jsuance to me of this permit I agree to perform the work covered hereunder in come ce with all ordinancel end regulations
pertaining thereto and in st i t conformity with the plans, drawings, statements or specifications submitted to the prop authorities of Miami Shores Village. In ac•
cepting this permit I assume trsponsibility for all work done by either, myself, my agent, servant or employee.
`.,1 CONTRACTOR OR BUILDER BY AUTHORITY ABBOT
MIAMI SHORES VILLAGE, FLA. 10 7004
JOB C } l��t
ADDRESS °7 Y P /0
INSPECTION 7rt-e,
TIME READY /•,‘
'- -
REMARKS •
o
INSPECTOR_ DATE