FENCEel
BUILDING INSPIECTION 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.
Own:i s Name and Address._. _ Donald S. Zern N 1065 Street N. E. 96th Street
Regiaered Architect and /or Engineer.._ _
Name and address of licensed contractor_
Location and legal description of lot to be built on:
Lot.. 11 & W 10 Block 82 _. Subdivision Miami Shores Section 3 ia2x 1Q -37
Street and Number where work is to be done 1065 N. E. 96th Street
State work to be done and purpose of building (by floors)__ n tall__l96 of 48" hi h res idential Chain link
y Fence
and for no other purpose.
New Building _._ Remodeling Addition fence Repairs._ No. of Stories.....
To be constructed of
CIL
MIAMI SHORES VILLAGE
..- Fence Masters, Inc., P.O. Box 176,---Miami, Florida 33135
Kind of foundation_
Estimated Total cost of improvements $ 275.00 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 fot said building. All notices
with reference to the building and its construction may
be sent to...._ Fe ce__Mas ers Ins . _. _ P.O. Eox_.17.6_,___Mi ini, F1or cla -- -- ..... 33135 - _
The undersigned applicant for this building permit dot hereby certify that he understands and accepts his obligations as an employer
nanent Supplement,
ntracto,s emplo ed by him
of the grk such . lblic notice
perform under this
of labor under the Florida Workmen s Compensation Act. being Sec :ion 5966, Compiled General Laws of Florid
and has complied with the provisions thereof, and will require similar compliance from all contractors or su
in the work to be performed under this permit; and will post or cause to be posted for inspec ' n oryt)► sit
or notices as are required by the Act. The undersigned agrees to ernploy only such subcontr wor
permit, as are licensed by Miami Shores Village.
Remarks _ __ _. _ ._. (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
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.
/(5`44 Date
Permit No
Disapproved ____ _
( Signed)
Chatnnan _
Member
Member .
Council Approved .___.._.
Date_
Roof Covering
6.00
Date_
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspecto j My Commission Expires
PL J NING BOARD_
DATE
Member
Member
Member
Date Disapproved
September 15 69
75' X
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.
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f S'