558 NE 96 St (4)Application is hereby mode for the approval of the detailed statement or use plans and specifications herewith submitted for the build -
ing or other structure herein described. This application Is made in complianci 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:
Owner's Name and Address
BUILDING INSPE(:TION DEPARTMENT
APPLICATION FfiR BUILDING PERMIT
Registered Architect and /or Engineer /" Je.• •r. rw•• Cn,m.ee• - ete.
f(A) /A C..Y,. �A �1 �' � .3v /� l�✓f ( f ,P
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot. 10.1. *4111 5 Block s SubSlivision.....211... a 9" ...._..._
Street and Number where. work is to be done _S • Sr... : _...
State work to be done nd purpos of building (by floors) / `ch
Disapproved
(Signed)
_.._.– .............. � and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation RoofCovering _..—
Estimated Total cost of improvements $ �� Amount of Permit $. ?.�.1.
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 under applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Lihur under the Florida ‘1'orkinen•s Compensation Act, being Section 5966, Compiled General Laws of Florida, Perinxnrnt Siip,lruient,
and has complied ssith the provisions thereof, and will require similar compliance froin all contractors or sub - contractors employed by hips
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 subcontract° s, on work to be performed under this
pcnnit, as are licensed by Miami Shores Village.
Remarks (Signed)
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-
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
thcrcin by him stated are true.
Permit No.._..2� Date ! Read, Sworn to and Subscribed before me.
..1i,ir
Building Inspector
MIAMI SHORES VILLAGE
Date
PLANNING BOARD DATE
Chairman Member ......._ ......................._ ._...._...._........_.._...._._ ....._......._..._
Member Member
Member.. .. ` Member ...._ ....... .........__.._._..._......__ _ ...._
Council Approved Date Disapproved Dale
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has burn obtained from
the 1'Lrnnir... Board.
A re- inspection fee of 31.00 will be charged when such re- inspection is made necessary by Improper notice for inspestiirsn or faulty
materials ami /or workmanship.
Date , 195! .
-30
e /? /1
Notary Public, State of Florida
My Commission Expires
me well known,
!,:r 1,11; ",:
DIV.
64
DATE
STORE ADDRESS CITY STATE ZIP CODE
STORE PHONE
CUSTOMER'S NAME
HOME PHONE
OFFICE PHONE
ADDRESS CITY STATE ZIP CODE
INSTALLATION ADDRESS IF DIFFERENT. . / CITY r,STATE ZIP CODE
i..>� / ,es (../r, / G_ i i3 S S< G
TYPE FENCE SPECIAL INSTRUCTIONS -
FENCING KEY: TIE -DIPS X BUILDINGS`
TERMINAL POST 0 WALK GATE C/ /
FENCE / G' — 3 , (GET PERMISSION) LINE DIAGRAM TO BE \ a
*M 7
ERECTED - EXISTING FENCE DOUBLE GATE b
,.
OVERALL
LENGTH
OVERALL
HEIGHT
•
J
WALK
GATE
DRIVE
GATE
2.-
CHAIN
GAUGE
--
LINK .
•
KNUCKLE k
UP
i l I I t,
B UP B ❑
DIAMETER
TOP RAIL.
DIAMETER
TERMINAL POST
DIAMETER
UNE POST
LINE POST
SPACING
.
SPECIFICATION - SPECIAL WORK TO BE .
PERFORMED BY CUSTOMER
A. FENCE TO FOLLOW ❑
SLOPE OF GROUND v S /
B. FENCE TO FOLLOW
CONTOUR OF GROUND ❑ �
C. FENCE TO BE LEVEL C / e )L /(e. /) f/
WITH HIGHEST GRADE ❑ />
D. FENCE TO BE LEVEL
WITH LOWEST GRADE ❑ .
E. FENCE TO BE LEVEL
AND SPLIT THE GRADE ❑
LINES CLEAR OF ❑
OBSTRUCTIONS
LINES STAKED ❑
WITH CUSTOMER
DISCUSS WITH CUSTOMER
ATE
WRI POST A LSO
SWINGS ON ALSO IF
GATE SWINGS IN OR OUT
• \ •
-
/ Q
"j
FENCING ESTIMATE AND PROPOSAL
2 IN TALLER COPY SEARS, ROEBUCK AND CO.
DIRECTIONS OR ADDITIONAL INSTRUCTIONS
INSTALLATION ESTIMATED
TO BEGIN WEEK OF
I understand that this is only an estimated date and I will be
contacted prior to this date to schedule the actual installation date.
INSTALLATION CLERK - Enter below on File and Installer's Copies:
Contractor's Charge
For Delivery
(Charge Acct. 116)
Contractor's Charge
Work Specified Above
(Charge Acct. 187)
Or)
47 75 . &
NOTE TO CONTRACTOR: SEND BILL FOR THIS WORK -TO:
SEARS, ROEBUCK AND CO.
(Address)
�a
STORE NO.
(Contractor)
(Address)
No. £
(Permit No.)
SALESCHECK NUMBER
(City) (State) (Zip Code) (City) (State) (Zip Code)
14541 -010 Rev. 5/83
To Contractor:
The customer named on the reverse side, wishes you to proceed with the installation at the specified address, of
materials specified on the reverse side and /or-on attached sketch or specification sheet. By the acceptance of
this order you agree to protect and indemnify said customer and Sears, Roebuck and Co., from all claims or
demands on account of- injury to persons or property occurring during or as a result of said installation. You are
responsible for payment of all contributions and taxes due under and for all requirements of Federal and State
Social Securiryy and Income Tax laws with respect to any payrolls incurred in performance of the work herein
specified. These provisions do not in any way amend or modify any other agreement that you may have with Sears,
Roebuck and Co. On completion of the job, you agree to obtain the customer's signature on the Letter of Satis—
faction below, and execute the Waiver of Lien, submitting both to Sears, Roebuck and Co., along with your invoice.
WAYS TO B <ASTALL FENCE
(A) FENCE TO FOLLOW SLOPE OF GROUND, TOP RAIL TO BE STRAIGHT (CUSTOMER MAY FILL IN LOW SPOTS LATER)
;:) __d_ . " :... G .i. ,. I': 5 :-015)
(3) ;': C :? .'C+ .'G'.:.; "W CO?! O;. O; %:3') :iND (301 TOM ic;Zi;° i0 a iN CONTACT WIT;- C„7UN0)
L. `. + , V: (CUSTC :.2 J■ItA1' IN ;...0)V SPCi'S
:Y1 5
•