805 NE 95 St (2)a
q * PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 4
Date 9 1 Job Address % e0,5 /U/_' q 5 -f Tax Folio /(— .3206 - 0 / q - 2 ?'3)
Legal Description / Historically Designated: Yes No
Owner/Lessee / Tenant 7 )� (� /G �G s h1e/ ij y' /,S Master Permit # �� q s 3
Owner's Address & 5 iv E ?- 51 Phone � 8d -- 2 � ? L f Li 1 6 rs / —
Contracting Co. _l . �:Ul� /7 ��rc% /G C ' R9 Addres� �3 /(ic } 53 T r/Ylro -n ( �'
Qualifier / r C r c/o (iCSV t: --? _ SS# 5 Phone e"s/ 26S?? Z
State # C« % 4/ 6i?0 a Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
y� ✓'m1
�' rC e 11/15/0 0 1D y �J 4 — ate ��v f r �c1o�`
WORK DESCRIPTION)'
Square Ft. Estimated Cost (value) r v er)G
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.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the wor c1)tated. 1'
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT 0 RADON
C.C.F. ° NOTARY
Electrical
•
-- ats
rgnah of
, 1
tary as to Contrac
My Commission Exp
roy o b i . - Builder
- a s3G - gal 4 q- 3s -6-
it or Own:,, ,�� VILLA%
WARY P 1 •U::C .I .' :Th. OF FLORIDA
COMMIc:SION NO. CC/141t33
Mme'; COMMISSION EXP. MAR 1
BOND
TOTAL DUE
date C �
/5
Date
APPROVED:
Zoning Building
Mechanical Plumbing Structural Engineer
DN.
10
DATE .
- 3O
ADDRESS CITY STATE ZIP CODE
UNIT PHONE
CUSTOMERS NAME -
» P 3 Pfr7 !9 rc '4 Pr 4 - C tF a /4 A 4 K
HOME PHONE
?,3 S S-1-..,0
WORK PHONE .
ADDRESS CITY STATE ZIP CODE
% ° 7V t ci' 1 S : l'h)4 rr) SNaii' 3313
INSTALLATION ADDRESS IF DIFFERENT CITY STATE ZIP CODE
TYPE FENCE
CHAIN
LINK LAi WOOD ❑
REM # /DESCRIPTION
SPECIAL INSTRUCTIONS
_ ;
IEESRMLSSIaa) ■ suI1
FENCE .
FENCING . I K EY : 1 UNE
TERMINAL POST 0 WALK GAT Cr o
g EXISTING FENCE xXxxx ' DOUBLE GATE crb
• DIAGRAM E
•
. .
TOTAL LO.F.
LENGTH
FENCE
HEIGHT
GATES
ITEM #/TYPE
OUAN.
WIDTH
HGT.
• • •
• .
-,
D
)
/ L
SPECIAL WORK TO BE
PERFORMED BY CUSTOMER
SPECIFICATION
.. • •, 4
•
CHAIN LINK
FABRIC
REM # /GAUGE
FABRIC
ITEM # /TYPE
1 1‘ b.
ji • ..... •
° ' : / "j
- C
t
ITEM # /DIAMETER
THE FOLLOWING POINTS HAVE
I
� , , .
> • • • T• 4 by
.A b
' "
TOP RAIL
/ 3
BEEN COVERED Wm1 CUSTOMER)
ASSOCIATE NRULS
(S EE REVERSE SIDE OF THIS ESTIMATE
AND PROPOSAL FOR VISUAL f�SCRIR
T1ON) FENCE TO
A) FOLLOW SLOPE OF GROUND ❑
B.) FOLLOW CONTOUR OF GROUND ❑
C) BE LEVEL WITH HIGHEST GRADE ❑
D.) BE LEVEL wing LOWEST GRADE 0
E.) BE LEVEL AND SPLIT THE GRADE ❑
UNES CLEAR OF OBSTRUCTIONS ❑
ONES S T A K E D WITH /BY CUSTOMER ❑
GATE LOCATION /SWING DIRECTION ❑
PERMfT RESPONSIBILITY ❑
CONTACT UTILITY COMPANY ❑
♦ o . •
• • • • • • • • . • . . . • .
. . . . . . . . . . .
. / • • •
a
. . . . . . . . . . . . .
. . . . . . . . . . . .
UNE POSTS
/ 31 t
TERMINALS
WOOD
"1'' • t
. . . . . ., • . . • . . . • • • • • • • • • . . . . . .
. . . • . • .
. . . .
. . . . . . • . . . . . . . . . . . . . • . . . . . . . . .
• . . • • . • • • . . . . . . • • • . • . • . . . . . . . . . . . . . .
• • • • . • . • • • .
. . . . • . • . . . . . . ... .
• • . • • • • • . • • . • . • . • . . . . • • • . . _ . • • . . . • .
Z FENCING ESTIMATE AND PROPOSAL
1 CONTRACT COPY SEARS, ROEBUCK AND CO.
CUSTOMER INMALS
INSTALLATION ESTIMATED
TO BEGIN WEEK OF
CASH .
PRICE '
❑ SC /HIPS ❑ CASH
❑ POC ❑ DC
0 /k/
I agree to locate and identify the property line easements and all underground cables and pipes. I agree that I am solely
responsible for the location of the fence described in this proposal. I will also defend Sears and reimburse them for all costs in connection with any claims
made by anyone about the location of the fence. I am responsible for any special work described in this proposal.
I agree that Sears has the right to make additional charges if unusual ground conditions hinder the installation. Such
unusual ground conditions may be rock formations hidden foundations tree' roots and other similar obstacles. Any charges necessary to satisfactorily complete
the installation will be based on actual additional labor, equipment and material costs.
Responsibility of Buyer
Unusual Conditions - Additional Charges.
333
SUBMITTED BY
s Signature)
/I -2
Customer can buy
at this price until (DATE)
MOORE SPEEDGET ® p ®- PATENTED 7219D
For information regarding
your installation call:
No.
SALES ASSOCIATE NAME
SALESCHECK /GOMC NUMBER
I understand that this is only an estimated date and I will be
contacted prior to this date to schedule the actual installation date.
(SALES ASSOCIATE) APPROVED BY (MGR)
(ADDITIONAL PROVISIONS OF THIS PROPOSAL ARE STATED ON REVERSE SIDE.)
(Space's Signature) - (Date)
UNIT NUMBER
If sale is made in location other than Sears premises, YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME
PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THE TRANSACTION. SEE THE ATTACHED NOTICE
rtc r` Aldr`FI 1 ATIrilkl PC RM F1'1R_ AALFYID! AMATICIAI nR