443 NE 95 St (10),.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date i /O - 92 Job Address '/- A/ e. .57 Tax Folio / 3� 9 6 / eW e
Legal Description ��5 °►' `✓ a� y �� Vt'/
Owner / Lessee / Tenant — // / 0 1 /0 / t /5r C... 'fltl/7'Jj Master Permit W:
. / C�lt� /la�
Owner's Address *:3 Nf _ 95 ST
Contracting Co. a// /r,&7 Address 9/95 b'L)•_ --
Qualifier /// /rip() SS4t - Phone 3/0 - J 19 j 6' 9.3- 75
State # 9559 A Municipal # Competency 4.5i0 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING AA ME ROOFING PAVING' SIGN
WORK DESCRIPTION 9g . S ll /y/l ,S9 , 1r (/4.IILI .!1/ll( 7e4 P,
AA DO
Square Ft. 1- Estimated Cost(value) 02/4)
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 constructioq and zoning. Furthermore, I
authorize the above -named contractor to do the work stated. .4,:c:;' JOSEPHINE CHURCH
1&_, :Notary Public, Sae FINIM
2 :MY COMMUNE be. lad II
Signature of owner and /or Condo President Signatupq of Cc� ��• �'�l}r - Builder
Date: D / A� -
� ,
�u�C lsto . r�m •_ i r • i
ary as to C. errsona y mown ':_i nu EUk i' �
$ cr ,4'rttunber i.D. pro luced:
DID take an oath, or �,
** * * * * * * * * * * * DID N4T take atitoath. * **
FEES: PERMIT 0 RADON C.C.F. c , l t NOTARY 5. TOTAL DUE ,./5
APPROVED: Fire Other
Notary as to Owner and /or Condo President
My Commission Expires:
My Commission
Phone 75/-2961
j- / / 2 `1=1� Electrical
Mechanical Plumbing' Engineering
10
CUSTOMER'S NAME
ADDRESS
INSTALLATION ADDRESS IF DIFFERE
TYPE FENCE
CHAIN
LINK 0 WOOD ❑
ITEM # /DESCRIPTION
V r—r
Cij u f r r'5
TOTAL LO.F.
LENGTH
t13a 7
DATE
yr► 1o' f ' '
FENCE
HEIGHT
ITEM # /TYPE
WIDTH HGT.
4.
FABRIC FABRIC
ITEM # /GAUGE ITEM # /TYPE
tr
ITEM # /DIAMETER
TOP RAIL
LINE POSTS
U
TERMINALS
WOOD
SPECI
Contractor's Charge
For Delivery
....• _oft TT., \I P'trin LJW;T1 TRAP TTT> =C rip nunF r.niiN - .
FENCING ESTIMATE AND PROPOSAL N
SEARS, ROEBUCK AND CO. SALESCHECK/GOMC NUMBL
NIT ADDRESS
INSTALLATION ESTIMATED
TO BEGIN WEEK OF
SEARS, ROEBUCK AND CO.
CITY
SPECIAL INSTRUCTIONS
SPECIAL WORK TO BE
PERFORMED BY CUSTOMER
THE FOLLOWING POINTS HAVE
BEEN COVERED WITH CUSTOMER'
(CATION
ASSOCIATE INITIALS
(SEE REVERSE SIDE OF THIS ESTIMATE
AND PROPOSAL FOR VISUAL DESCRIP-
TION) FENCE TO:
A) FOLLOW SLOPE OF GROUND ❑
&) FOLLOW CONTOUR OF GROUND ❑
C.) BE LEVEL WIT HIGHEST GRADE ❑
D.) BE LEVEL WIT LOWEST GRADE ❑
E.) BE LEVEL ANC SPLIT THE GRADE ❑
LINES CLEAR OF OBSTRUCTIONS ❑
UNES STAKED WITH /BY CUSTOMER ❑
GATE LOCATION /SWING DIRECTION ❑
PERMIT RESPONS BILITY ❑
CONTACT UTILITY COMPANY ❑
DIRECTIONS OR ADDITIONAL INSTRUCTIONS
NOTE TO CONTRACTOR: SEND BILL FOR THIS WORK TO
(Address)
FENCING
DIAGRAM
INSTALLATION CLERK: Enter below on File and Installer's Copies:
CITY
KEY:
CITY
Contractors Charge
Work Specified Above
(Charge Acct. 183 -82)
STATE ZIP CODE
HOME PHONE
TIE -ONS
(GET PERMISSION)
FENCE
UNE TERMINAL POST 0
TO EXISTING FENCE XXXXX
SALES ASSOCIATE NAME UNIT NUMBER
UNIT PHONE
WORK PHONE
STATE ZIP CODE
5 won e, 3 /3?
STATE ZIP CODE
■ BUILDINGS I
WALK GATE O 0
DOUBLE GATE Q(.:)
(Contractor)
(Address)
(Permit No.)
I understand that this is only an estimated date and I will be
contacted prior to this date to schedule the actual installation date.(