9723 NE 2 Ave (5)JOB #10064
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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.
Location and legal description of lot to be built on:
Lot_. Block .. _ Subdivision
Street and Number where work is to be done
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
`APPLICATION FOR BUILDING PERMIT
450 N.E. 91 St.
Date
shown on plans.
G. -Conklin, c/o Brandon Air Conditioning Corp.
August 18, tg 69
Walter Frederick
Owner's Name and Address._ No 210
Registered Architect and /or Engineer._.
Name and address of licensed contractor_ Brandon Air Conditioning Corp. -2475 W. 8th Lane, Hialeah
Street_ N.E. 98 St .
State work to be done and purpose of building (by floors)._ Install ( 1) 3 Ton A.C. with duct work as
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 $.1,410. 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 foi said building. All notices with reference to the building and its construction may
be sent to___
The undersigned applicant for this building permit doc hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen s Compensation Act. being Sec :ion 5966, Compiled General Laws of Florida, Pennanent Supplement,
and has complied with the rovisions 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,, work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks _ __ _. ___.. _ (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
C, Co
7
Permit No 1 ' Date. Read, Sworn to and Subscribed before me.
Disapproved
( Signed)
Chairman
Member
Member _
Council Approved
Date
Building Insp for
'P LANNING BOARD.
to me well known,
Notary Public, State of Florida
My Commission Expires__
DATE
Member
Member
Member
._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.