FENCE PERMITDate dt U " W5 Job Address / 5-6 ALE • 9V 'E7 Tax Folio
Legal Description
Lessee / Tenant
Owner's Address
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
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Contracting Co. 0/AS i iAi F&A/&; eo/nPAN /NC-Address P v 6(S /&e?
Qualifier
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State #C23CV-2.- Municipal #-- 0- ofacompetency # 0000D0L' Ins.Co. 1 /7 2 /E -4
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Architect /Engineer
Bonding Company
Mortgagor
Permit Type(circle one): BUILDING ELECTRICAL
WORK DESCRIPTION
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da7ZiLielaznco,D
ary as to Owner and /or Crarid�q PreS� aent
` �* JuuE ANN LUTERMAN
Commission Expires: ,4�: COMMISSION # CC 335111
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Ate? EXPIRES DEC 8, 1997
•,�p Bonded Through
** * * * * '4,� �` ALAN INSURANCE SVIVICFC*
FEES: PERMIT l" RADON C.C.F.
APPROVED:
Address
Address
Address
,11146 Cio;,9 Lif),
Master Permit # 3807 / I
Phone (3 g) 7 os 7
PLUMBING MECHANICAL ROOFING PAVING ,.. 1 . 71•25) SIGN
-
x/ 1'16 V 42— 6 F i)(1 STING Gu /` /4:/ ,, ) c1 .
/9/ F U ✓`-,e--4 — Estimated Cost(value) � .3(, / ° 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 accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I
au ze the above-darned co ractor to do the work stated.
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• Signature of owner and7or undo Pr=esident
Date: OFf - 9
ntractor or
Signature of • er- Builder
: 08 a��ll /6/414--
ry as to Contractor or Owner- Builder
CommissionAit ay JULIE ANN LUTERMAN
.mo •■ �- G&MMISSION # CC 335111
:0 � - EXPIRES DEC 8, 1997
OiR�P Bonded Through
* * � ,,. *t4JI INSUR1NCE SEVVICFS **
NOTARY TOTAL DUE l'ff'
Fire Other
Zoning Building Electrical
Mechanical Plumbing Engineering
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SURVEY OF
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SU BDIVISION 1 ttitel P EL:111
c:cortroteivi TO THS PLAT TrtaneOF AS" nEccirwolp IN PLAT ROOK
PUBLIC RECORDS OF__-2111 COUNTY. FLORIDA.
DATC: _dc'743,711./A.c.° / 9S_G_ _Fon. Liegt/5g_i_l_tiVrCH/Ndlii_.
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11 J. K7LLY
CIVIL ENGINEER—LAND SURVEYOR
FLORIDA
SURVEY NUMBER-5 6-114
BLOCK
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I HERESY CERTIFY THAT THE ATTACHED
SrETCII Pa A RECENT SURVEY P1A0. titanEn 14 y DIRECTION. AND IS TRUE AND CDR-
necr TO THE orr.ar or Ply KNOWLEDGE AtiO
BELIEF.
THERE ARE NO ENCROACHMENTS.
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PAGE NO.4? Q
TELEPHONE:
H. I. 8-0504
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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 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.
Date, a1i, , 19.4. >
Owner's Name and Address ✓� .... 09'1.e8J!_ No Z Street Z `4�`
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block , Subdivision
Street and Number where work is to be done 1— .21:: _ /v_f- )9 tr i ,-- - e)
State work to be done and purpose of building (by floors 4.0.- / /
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-
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements 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 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 obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Pennanent 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 agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed)
peared
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 '- / Date � " Read, Sworn to and Subscribed before me.
Disapproved , Date „
Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires
to me well known,
PLANNING 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 Board.
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.