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BP-03-711No • as to O My Commissi . n expires RECEIVE© PEI,MIT APPLICATION FOR MIAMI SHORES V LLAGE�� 0050 N.E. .E. 2nddAvent�^• Miami Shores, Florida 33138 • Phone: 305-795-2204 • F: !*305-7A-I Date-5 0 %3Job Address C37 I `• e 1 I Tax Folio 44 Legal Description Historically Designated: Yes No X Owner/Lessceft'enet till r4o R (111) r 4 Master Permit # B t, 0200 % Owner's Address bSU !J. 101 S4 Phone ('D 9 E Contracting Co. Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE -INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING NORKDESCRIPTION: /_-/1O J' gutd Square Ft. Estii t tad Cost (value) MO + 0 0 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 ANY 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 all disciplines. OWNERS AFFIDAVI: , ertify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws • regulating const uction . d zoning. Furthermore, 1 authorize the above named contractor to do the work stated. ,/2a3 of Contractor or Owner Builder Date Si nature f er and/or Condo President to Signature : ' o —(23 P ate Notary as to Contractor or Owner Builder Date 8 'fP.t2ooe My Commission Expires hitGateA 414 4 /4 FEES: PERMIT (RV 0 RADON C.C.F4944" NOTARY APPROVED:/ Zoning ae.aa ? Building Mechanical Plumbing BOND TOTAL DUE /1 • OD Electrical Structural Engineer rsutl�amng inspection Request Date Type Insp'n Permit No. Name Address Company Phone # Inspection Date Correction Re-Insp'n Fee tito re•e4Lee i,() O37,j J•acv 5-47) 4.)-6 0 I Cit le • terd►saaaleoInal pdAsNsd � t�YYelarsat%AWmese'r21114Eruniessil,•statY le he loftet Lade lla~t,�. �Y4 Daft" Pa op IX yypayee. Aea dime wyp EwCtr op Am*Ad ode i0e�t ^ Witoo aim case e.74fia'arw a�o�niv iddt .".rYger h�Oas ait► se'peates tits Ka4w/Weft as w it ,id� y�grc� eet W se. Rl le*rM► R After des b h N#st deft! Waal hies ^acesria edraeiekt ape( berm brzu rl�.r "MS P2OPEUTT D1SCeIE® AS: LOTS 1, 2 Aso 2, $LDC; $3, �1LA74I norrasS SECZLO3 in, ACCORDING TO VCR TLAT TORREOP. as Eemaa9D N PLAT GOON 15, PAss 1st or TSB Ma<t.TC Remain oi! DADS rxRiont, PICIUDA, - - CERZWEL® TO: VICTOR ORTEGON nm P 1ANDA ift= VERE ATTOpHIC1C3' 7LTLS INSU5ZISCB row, DM. TRANSAINCHASE �Mt�UASTACII U MAW USne A NA,� Ira SUC �SOAB aPD10a F1�A rat EiA45 1r.gs C'T4ftsJar 2) ee V1aigi.b E:FL' PoAGNKAa 40 a7 8 r PiDapEiTYAooRE9x_So HE WEST RNA a[GEX taw =KEN to it_ t016G '51'REe T'l MINH% slroixes. FL Rimwa(4w 8a 12o BA9<1l�D arcTali V Yee4 NDT VALO UNLE3s SEALEDWifH THE a aoSaEO SUL OP CERTIFYING SURVEYOR mosksysors IMOD WC( Ileap MAD OA le Trevi mil ea Ileyone Adak! 9erttlt sod to 1y 1t DAN exel of Wafer,/ Net 2 t -, -t Rile 3deaa'ast ads DM Rah, ;,,, , lnz A Sp. A l 7 MS E(KOWA ,I/A Alvarez, {uguesvlvea & A Protesslanal Land S 8230 Cord Way, &Rite 8, t (Y35)385-0385 i i 13`-.-CE23 (305)288-271 SW_ ea_ Gam+ QFOR RENT OFOR DATE 477 pri 7 No'i RECEIVED FROM .119X /Cif- E 4-: 04/ 2- 7 ACCOUNT PAYMENT BAL. DUE - k ASH °CHECK \JMONEY ORDER FROM „," TO 1182 "/".