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41884Date IS n-91 Job Address 1 t 3 00 41k Tax Folio Owner/Lessee / Tenant 6A -22-4 la ?J t J Lt T V Owner's Address l 1300 g'3JC, Contracting Co. i b T Sc-o...(2, T V SE-P-0 ( Cc-S WORK DESCRIPTION Signature of owner and/or Condo President Date FEES: PERMIT 3 5'r' eme' RADON PERMIT APPLICATION FOR MIAMI SHORES VILLAGE C.C.F. NOTARY APPROVED: Zoning Building Electrical Mechanical 11 - �13G -c)cw - 6ot Legal Description Historically Designated: Yes No Master Permit # 8V Phone ( r) T9 - 3c0(J Address t dS PC)vX-e-t. -t ILK- 1204 IJ. Qualifier 'TOO \( C!4 ( k) SS# Phone C3cri) Gag G state # E F 00 0 0 91 ( Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN skis-r€4-1 - 1 cawIedc, Pct &c_ - c teutces Square Ft. Estimated Cost (value) acts s .0c/ 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. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin Furthermore, I authorize the above -named contractor to do the work stated. -c- P}1 TM C r--L sic, du 4 71,4_19 Signature of Contractor or Owner- Builder Date Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date My Commission Expires: My Commission Expires: BOND TOTAL DUE Plumbing Engineering Si a e of owner and/or Condo President APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date — f 9 -7 Job Address // 0 0 4./� 2 Q(...e 1/ 2 /3 C - 2O 9 Q V O Tax Folio Legal Description I Iistorically Designated: Yes No Owner/Lessee / Tenant 13A C? I - Zt t (/-Q & 4 c 67 Master Permit # Owner's Address / D3© v it/ f' 2 A Contracting Co. 4 0 r .ae /A 4 - t El` c'E Address 1V, S \cLkki21,11l€ Rb Qualifier TON e._ r l 1 J ss# Phone to `M710 State # 0 0(T) q11 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION A 1A17.-wt. 7 Square Ft. Estimated Cost (value) 21/25-°/ WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT PI 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. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. a ►ai+011 kralossad tt Notary "O er andor My Commission Expires: 66 4011 - LARRY J. 11911f" , Goa Exp. 4f03/99 Bonded By Service ltd No. CC431310 I I itoeeeu x i j aa„ FEES: PERMIT RADON 17 47 Date C.C.F. Building Phone (3O) $'79 -300 d, No to C. '_ a or Owner - Build- Date My Commission xpires. NOTARY TOTAL DUE Electrical Plumbing Engineering