FENCE PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ( e Job Address ,37 5 N 5 /Sf Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant bIG1lle r Limn' Ha rc / I3rlL /I y Master Permit # Ic1 `/
Phone . 75/ — 7 0 5
3 ?S i\O, ?1 $ [-.
it
Owner's Address
Contracting Co.
Qualifier
SS#
State # Municipal # Competency # Ins. Co.
Address
Architect/Engineer
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN a FENCE SIGN
9 44-e-
WORK DESCRIPTION
5
build l kvocte,f1 e
Square Ft. Estimated Cost (value) 3c0.
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 contrac .r to do the work stated.
/ I
Oer
Signature of owner and/or Condo President Date Si P 'tractor or Owner - Builder Date
, 1
4'
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date
/a7 /q7
My Commission Expires:
FEES: PERMIT
APPROVED: qr � 't1 Zoning Building 3 1 l
Mechanical Plumbing
Address
My Commission Expires:
RADON C.C.F. " NOTARY BOND
Electrical
Phone
ctn0 e,1444:n ( t n k
7
Engineering
FOUND I/2 "
IRON PIPE
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20
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1309 S.E. 1St STREET ACCURATE LAND SURVEYORS, INC.
(954) 782 -1441
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pla nters
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NOTE
BEARINGS SHOWN HEREON ARE BASED ON A BEARING OF N/A
ALONG TIIE LINE OF
PLAT BOOK PAGE COUNTY RECORDS.
NOT[: TN[ LANDS •MOWN N[N[ON W[RT NOT A•ITRACTTO ION OWN[N[NIP. RID MT••OI.W AY ON CA[[N[
CERTIFICATE THIS SURVEY IS FOR TITLE AND MORTGAGE PURPOSES ONLY
THIS IS TO CERTIFY THAT 1 HAVE RECENTLY SURVEYED T1-1E PROPERTY DESCRIBED IN THE FOREGOING TITLE CAPTION AND HAVE
SET OR FOUND MONUMENTS AS INDICATED ON THIS SKETCH AND THAT SAID ABOVEGROUND SURVEY AND SKETCH ARE ACCURATE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. 1 FURTH 1I1 CERTIFY THAT THIS SURVEY MEETS THE MINIMUM TECHNICAL
STANDARDS FOR LAND SURVEYING UNDER RULE (o16I7.6 F.A.C. ADOPTEO BY THE FLORIDA BOAr!D OF LAND SURVEYORS. MAY 1995•
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18 asphalt
ST REET
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of 5' .�
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Pompano Beach, FL
33060
L 0 T
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105.65 P
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FOUND
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j IRON
PIPE
2 I'�
SE AL
HOY VALID UNLESS
SEALED HERE WITH
AN EMBOSSED LANG
SURVIETOR'i SEAL.
NTS
PROFESSIONAL LANG SURVEYO R NO 3BG9 •STATE OF FLORIDA
ROBERT L. TIIOMPSON I A /- 9
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