FENCE PERMITOwner's Name and Address
MIAMI SHORES VILLAGE
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 building 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.
mg y
Date %5.--
No. •--.4'.g/
/ �9 19
Street we9/
ei4e /6 dr 979 d6
Registered Architect and/or Engineer
Name and address of licensed contractor e:%1,46/4/116' e:%1,46/4/116' Location and legal description of lot to be built on: // r
Lot I' "0Z Block Subdivision ? Y / ��'L�
Street and Number where work is to be done A ! d
Vt ate work k be d one and o d of b 'm ld' Ib fl ), state ex to ' rtor c lors (submit
samples)
and for no other purpose.
No. of Stories
New Building Remodeling Addition Repairs
To be constructed of / ' v
Kind H of foundation Roof Covering
1/Estimated Total cost of improvements S (0 ° ' . Amount of Permit S , 3 414
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live Toad to be borne by each floor
I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's
Compensation Act, being Section 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 inspection
on the site of the work such public notice or notices as are required by the Act. The undersigned agree to em only (rch subcontractors, on work to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA
COUNTY OF DADE.
1 SS.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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. C g - Data f/ Read, Sworn to and Subscribed before me.
Disapproved . Date
\01 Vdr' "
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.
Notary Public. State of Florida
to me well known.
Date 4 9g Job Address 99O sr Tax Folio //-306-0/7-o..53 o
PERMIT'APPLICATION FOR MIAMI SHORES VILLAGE
LegrJ Description 47g / Yom # /k 3 0 Historically Designated: Yes No
Owner/Lessee / Tenant k Master Permit #
Owner's Address 0 4/6 7/ 6r
Contracting Co. at 49A, if a, 0�NE Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer 5 *Jo/Kl► e/✓oy/6"1( / / / . e Address # 40 SiQ(/e Att;
/ 4/1 p7
Address g31.s
Bonding Company
451.C-S-72---
Mortgagor /t/ow Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ?/S6
'VC °- 4. - etl2 ' �i94a1∎11,B/o& - i iv7 d €V,te1 ?�/T/
,9e
Squire Ft. 4
Estimated Cost (value
P hone 757 6
6000 ; OZ�
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 accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date
7
Signature of Contractor or ef- Builder
.
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date
My Commission Expires:
''' /1.
My Commission Expires:
FEES: PERMIT
.rz
prd'
vr-
RADON
APPROVED:
Zoning Building
C.C.F. / NOTARY nd TOTAL DUE
Electrical
//Data
Mechanical Plumbing Engineering
S /rte. S /i6h6
DST
#
A. CONC.
CELL
:AN SOr RY
3TL BAR
x10" CONT.
WALL. .
ELEV.
■
25.22' •
EXIST. 3' -0"
WALK WALK
- P ROP.
3FT
GATE
N.E 3rd AVE.
P ROP. 16FT
SLIDING GATE
(MFR TO FIELD
VERIFY DIMENSION)
AY FEET
109.99' A+
• • •
A 4-
135.00'
ri
26.9'
27.0'
0
0
5FT HIGH
MANSONRY WALL
FENCE W/ 2 #5
VERT. IN CONC:
IN CONC. FILLED
BLK CELL AT
EVERY 16' -O" 0
AND 8" x8" CONC'
CAP W/ 2 #5 CC
PRQVID;
16' x 1 O CONT.
FTG UNDER WALE
(SEE SECTION B: