MECHANICAL PERMITA-' PLICATION FOR B I ILDING PERMIU
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the huiEd-
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
glans and specifications must be kept at building during progress of the work.
Ov r s Name and Address._. Mr. & Mrs. C.C. Nielsen No 490 street . 0 91 S`, o
EteglItered Architect and /or Engineer.
Name and address of licensed contractor_ Central Air Condo & She 1b1e :a1 fl Inc. 900 S.J. 70 Ave.
0
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).
Supply & Install Carrier 4 ton Split System Heat Pump
and for no other purpose.
New Building Remodeling ._. Addition Repairs X No. of Stories
To be constructed of Kind of foundation___ Roof Covering._ ... ___.
3497000 8000
Estimated Total cost of improvements $
Zone cubage required
Distance to next nearest building__
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._ _._ Centres l Air Con d. o & Sheet Metal , Inc. 900 S00 70 iemae
The undersigned applicant for this building permit dot 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, 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 inspe ion on th site o the work such )ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such subcon ctors o oak , be perjo under this
permit, as are licensed by Miami Shores Village. � , i / /
Remarks -- - - _____ - - ( Signed) - ,. ( - i r-- 1/1 • /�___ / `,_ /
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, h: undersigned authority, a notary public, duly authorized to administer oaths and take ac'-caowledgments, 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
Disapproved
A I
(Signed)
Ch.alnnan
Member
Member .
Council Approved_____._-
MIAMI SHORES VILLAGE
BUILDING INSPECTIt DEPARTMENT
490 No E
Date _
Building Inspe for My Commission Expires__ _.
PLANNING BOARD__
NOTE: A charge of $1.00 will be made for
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
_Date
91
Street
Amount of Permit $
.Plan Cubage. _.
Size of Building Lot
Date - January 19 9 fl 1
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
DATE
Member
Member
Member
Disapproved
Date
making corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
Location and legal description of lot to be built on:
Lot_. Block
Street and Number where work is to be done
Disapproved ____ _ ) �►
( Signed) � G - `> ° -
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted ffo7 the bui3d-
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.
Jau txs,7 ag, .
Date , I .-
Ng Ow� °z s Name and Address. -- -- __ -- -. -- •--------- - --- -- -- Street_ " -- _ --
IRe Architect and /or Engineer..- _ -
Name and address of licensed contractor_
Co 3 . Ag. r' Co 1. & Moot L..ot 1, `gm e 7 = -:)... a ` 3 Ave.
State wont to be dg�1 pure se E3 r 2 (by fl il ). o 6 t
Date_
S vin -_ -.. ot
LD3t SyOtOp
and for no other purpose.
• ei
New Building Remodeling _ Addition Repairs GO 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 net nearest building... . .. Size of Building Lot
Maximum live load to be borne by each floor.-_
11 hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may
be sent to__ Contr,31 6 g C.oPA. 81 Macet C- Wotab 1zo. gi cu s..., • v J n2G,2 O
The undersigned applicant for this building permit dot 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 provisions thereof, and will require similar compliance from all contractors or sub- tractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspe 'on on the site o , he work s,h public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcont cto , �n� wor /,&o P per orned under this
permit, as are licensed by Miami Shores Village. �+� /
i
Remarks _ • - - -- - - -- - -- — (Signed) „ - 7 , - ,, ��
------------ - - - - -- rte ",' � - ---��—
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, ;z: undersigned authority, a notary public, duly authorized to administer oaths and take a.'t.iowledgments, 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 -- --- - - - - - -- - Date__
,[ � 7 .. ____ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires_.
PLANNING BOARD__ __ . DATE
Cha nnan 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.