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215 NE 98 StBUILDING ELECTRICAL PLUMBING HOOnIta Owner of L / Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA Li ❑ PERMIT N? 6003 Work to be performed under this 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 application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans 11637 — This �rni1t may be revoked at any ler condition upon which this permit is f the ordinances and regulations d that he Ls responsibility for work lrawings, statements or specifications that may have been submitted to and approved by the proper municipal auth time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough kno uertaining to the work covered hereby whether shown on the plans or drawings or )n the state nts or specificatiops done by his agents, servants or employees. J f INSPECTOR Signed. Subdi- vision BY /- DATF S 3 Contractor's License No. S -) Project $ Permit $ qs.. • Value of !� II Amount of I� In consideration of the issuance to me of this permit I agree to perform the work covered hereun .. in compliance with all ordinances and regulations ,ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted . the proper au.horities of Miami Shores Village. In ac• ;epting this permit I assume responsibility for all wflcle -dgne by either, myself, my agent, servant or e..loyee. AUTHORITY 195 Building Inspector MIAMI SHORES VILLAGE 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._ No l Street Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) BUILDING INSPECTION DEPARTMENT 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 $ 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, 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. 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- pea *ed and who, being by me first duly sworn, upon oath deposes and says that h . is the of the above described construction, that he has carefully read the foregoi g applicati and that he did sign the same, and that all facts therein by him fated are true. e Permit No + r Dat Disapproved 3 i Date ,. (Signed) Date to me well known, Read,"5wprn to and Subscribed before me. Not'Publie, State of Florida ,19 c ommission Expires PLANNI 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.