MECHANICAL PERMITtherein by him stmt
Permit No.______
Disapproved ___ _, •_ Date_
( Signed)
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Registered Architect and /or Engineer
Name and address of licensed contractor E.ta R 0,_ 2vC. 4_— a2..U.
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)____LJJ IA . . TOtJ 5f'LjT C/A/C.—
Suet DLLT \\ oRK -To . _t 1c
Read, Sworn to and Subscribed before ins.
Notary Public, State of Florida
My Commission Expire
147
1025
Application is hereby made for the approval of the detailed statement of the plans and specifications barewith submittal for tut bulk'.
ing or other structure herein described. This application is made in compliance and conformity with the Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida all ordinances of Miami Shares Ya turd a1 Wes sal
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A espy ad approved
plans and specifications must be kept at building during pregrea of the work.
Date ÷ `+sv 73 .l11 --
Owner's Name and Address Ani au -^�- BfsMR .OJ • E '� �'' "`'
and for no Mbar porpoise.
New Building Remodeling / Addition Repairs:... .._ -_ ..,.. . No. of Stories.._._—_---_
To be constructed of Kind of foundation
Estimated Total cost of improvements $ 2-)0.1.0 • QZ) Amount of Permit f4
Zone Cubage required __...._----- - - -_ -- ___plan Cubage
Distance to next nearest building Size of Building Lot._
Maximum live load to be borne by each floor
1 hereby submit all the plan and specifications for said building. All notices with reference to the building and us ctuutraction may
be sent to
The undersigned applicant f this building pennit does hereby certify that he understands and accepts his oblaggaations as an rmployer
of labor under the Flo Wort men's Compensation Act, being Section 5966, Compiled General Laws of Florida, Pennarnnt Supplement.
and has complied with the rovikions thereof, and will require similar compliance from all contractors or sub - contractors ma loyed by hire
on the site public
be performed tender this
in the work to be perfor un er this permit; and will post or cause to be posted for i
or notices as are required y the Act. The undersigned agrees to employ only such su
permit, as are licensed by, Miarn Shores Village.
R emarks.- • ---•- •-- -------- •-- r --.__.
STATE OF FLORIDA, !`
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and tab ackuowledgmeats, personally ap-
peared • -_ - -- __ __�
to me well known,
and who, being by me first dui sworn, upon oath deposes and says that he is the. .- _-- ____.-- ..- .-- ________ - -• -»
of the above described , that he has carefully read the foregoing application, and that hs did sign the same, and that all facts
PLANN C BOARD - -_ _ -_DATE
Chairman Member
Member __._._.. __._� . _- •-- --- _..__--- _ --- -__ Member —
Member — . __... »._ - --- __.._.__
..-- ___. ---_ — Member
Council Approved- _- _.____ _Date Disapproved .Date
NOTE: A charge oi: $1. a i will be made for making corrections or changes to this application after appsoral has been obtained from
the Planning Board.
A re- inspection fee of Si. t will be charged when such re- inspection is made necessary by improper notice for inspection oe faulty
materials and /or workmanship.
14154 (F.141265)
Sears
sus► .)
SEARS, ROEBUCK AND CO.
TO WHOM IT MAY CONCERN:
I have no objection to placement of Air
Conditioner at -1� - side of house at
/ 5' Z- Street
cj
Signed `' ` 41r
Address 1/ STS' N
fir shopping at Sears