1996 FENCEPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date / - 10 - 9C Job Address ? ii /3 1 N R 1 T a.Q f Tax Folio
Legal Description VAer Pe00 k. ( i Q4,£ t D Historically Designated: Yes No
Owner/Lessee / Tenant 0 ?. _� " 1a 2 Master Permit # 013)-
Owner's Address Ul )1 1 q 1 --rec2p_AcA Phone 7 S -0 (020 /7r 7 , 79
Contracting Co. Z S 1"C Address
Qualifier SS# �� - 2 -Phone 7 5 - 7 — Cc 00
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN FENCE SIGN
WORK DESCRIPTION %KSTRLL A 4-w4c. y F re Sl ' .4G4?Ars , e./74 - �/ 493 ' cOemvAi 7'1dc- K't.fT
1cg - Th se S' i4 .. 6 • Thy
shoes /0/V4 0/76 Arra1i ivy /Awe. /'7 • '444 Pr Ac7"Wia. 131r aCe0 Jii / A/ �,nry Fisrcr
OA' toMG z.e,m . M4 aoyus o ear ¢. s.,oe.s .
Square Ft. Estimated Cost (value) 4 -doe • 00
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accur and that all work will be done in compliance with all applicable
laws- regulating construct • • .1 : zoning. Furthermore, I authorize the above- contractor to do work stated.
4W
ature of owner and/or Co r President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT 7 RADON
Buiklin °it>
ature of Contractor or 0 : - Builder
j Y2
otary as to Contractor or Owner- Builder Date
My Commission Expires: / a —
C.C.F. • ('/lJ NOTARY 5:01) BOND
APPROVED:
Zoning
Mechanical Plumbing Engineering
Electrical
Date
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1774 W. Flagler Street
• MIAMI 35, FLORIDA
Telephones: 9-3508 82-0027
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I HEREBY CERTIFY that i attached sketch represents
a survey made under my lion and is true and correct
to the best of my knowledge and belief.
There are no encroachments dept as shown.
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REGISTERED LAND • RVEYORS 427
STATE OF FLORIDA
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According to the Plat thereof as recorded in Plat Boot -; -at Page.. /fie)
Public Records of Dade County, Florida.
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