FENCEAPPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement ur me plans and specifications herewith submitted for the build •
in; 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 iuilding Division of Miami Shores Village shall bc complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Ow.nci s Name and Address Kathleen Kelly — N 882 .». Street. 'i_9.1th..jt
Registered Architect and /or Engineer ..:,+ .<. all, rnr....
Name and address of licensed contractor .EirA1„.s :..C.o..
Location and legal description of lot to be built on: 4—O c I
Lot 5 Block 7 Subdivision. Miami Shores S tj,,on„3._ PB 10 Page a7
882 E. 9Zth_5:._ ._
Street and Number where work is to be done
MIAMI SHORES VILLAGE
Stato work to be done and purpose of building (by floors) ........
Install 4' Green Vinyl Chain Link Fence 132 Lineal Feet
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof _cpverin
Estimated Total cost of improvements $ Amount of Permit $. e, 40
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 perinit does hereby certify that he understands and accepts his obligations . s an employer
of lahur under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Snp ileurent,
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 bc 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 ..ntractors on w to be performed under this
pennit, as are licensed by Miami Shores Village. ,p
Remarks (Signed)
STATE OF FLORIDA, t .
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
therein by him stated are true. / / f.
Permit No.. 6 1 Date ' L 1 o1 _. Read, Sworn to and Subscribed before me.
Disapproved ..
(Signe
art nspcctor
BUILDING INSPECTION DEPARTMENT
PLANNING BOARD DATE
Chairman Mcmbcr
Mcrrlbcr Member
Member
December 28 8
Date...�..._...__...w.._._._.. �...._..._.__..._.... ,19..
/ail°
411 e
to me well known,
Notary Public, State of Florida
MyCommission Expires f.. ......_. _....._ .,.�
Member
Council Approved Date Disapproved Date
NOTE: A charge of S1.00 will be made for making corrections or changes to this application nfter 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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