MECHANICALiami Shores Building Department
0050 A.E. 2nd Avenue
Miami Shores, Florida
Dear Sirs:
Thi3 is to certify that I have no objections to
Air Conditioning equipment being placed on the
premises of Mr. and Mrs. George Hines, 1113 N.E.
98th St., zaid equipment being on the east side
of their house, adjacent to my property, and
facing my garage.
Mrs. Donal . Campbell
1143 A.E. 98th St.
Miami Shores, Florida
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.
Owner's Name and Address 9 1. vt. ,
Rogi§ttrod ArQliicPot and/or Engineor S! VL
Name and address of licensed contractor__.,
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done
Staje.,work to a done and urpose of building (by floors).
,
/7 v k
4 -{a-144.1
New Building
To be constructed of
Permit No
Disapproved
(Signed)
r
MIAMI SHORES VILLAGE
Subdivision
emodeling
Date
Addition
Date
1 14- t cis-
�� 2r
No /1.1 Street_ C ?
43.. ;= .,.` ,,,,,_( /.,(_,,, >?`�ln.`l�_� tai
.3 w l`t/ J 31
Kind of foundation Roof Covering
Estimated Total cost of improvements $ /c C
Read, Sworn to and Subscribed before me.
7/
and for no other purpose.
Repairs No. of Stories
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 p ans and specifications for said building. All notices with reference to the building and its construction may
be sent to '�r:y-Ct.� l.Stto Ls- `zi C,-, 3 C. 'N'1 - �'' • i 71 C 4 l b -- )v1. B
The undersigned applicant for this building perrnit 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 Sup 'lenient,
and has complied with the provisions thereof, and will require similar compliance from all contract or sub - contractors employe by him
in the work to be performed under this permit; and will post or cause to be posted for inspe io n th site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su con actors on ork to be p formed under this
permit, as are licensed by Miami Shores Village. 1 r /
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-
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 sled are e.
J 2 ,,1 Date_
Notary Public, State of Florida
ing Inspector My Commission Expires
PLAN G 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 13oard.
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.