41966PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 97 Job Address 4L //LZ /1/ SRf X"Tax Folio
Legal Description Historically Designated: Yes No
/ Tenant &Racy /)Aff t0 &5 / ry Master Permit # ,/ .76A
owner's Address //.3ce Nk102 E& e. ,S'7// /c'Es Phone 8 freddy 0 /oG-/
Contracting Co. C t1 A6 l 4 r/l) PE/ 0E- Com i4Ay , / IIJe Address too V7Ux b e2, /)7 / / R., 433/4
Qualifier - D4 I/ / A L Gal SS# Phone 00 5 (,p -65v/
/ imi al # r 3 0 9 °- # Or )(, )1 X / In s. Co. v�
� 0 � �/� C�et�y r� � , � �
M
state# 50 -o 2 3 o fl -
Architect/Engineer
Bonding Company , V f
Mortgagor NIA"
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN
WORK DESCRIPTION 4 lj/ c/L f'!C} aid gl er
Square Ft Estimated Cost (value) YQO 4 ` p
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
laws regulating construction and zoning. Furthermore, I authorize the above -named contract° work ted.
FoR- 13crrr1 tv- a-slk
Signature of 6ner and/or Condo President Date
A s, sec ('r 1 ec lr f1 3 Jd t
claw:ad e. 6 V:40 91
Notary as to Owner and/or Condo Presi t Date
My Commi ssio aExpires:
LOUISE C HARDENBURG
My Commission CC471184
Expires Jun. 12.1899
Bonded by HAI
800- 422 -1555
Address �—
Address
Address
Signature of Contractor or Owner- Builder
FENCE »SIGN
all applicable
Date
as to Contractor or Owner- Builder Date
Commission Expires: JULIE ANN LUTERMAN
o1Y e gg COMMISSION xt CC 335111
EXPIRES t).C. 1. 1997
1 ,` Bonded Through
1 ALAN INSURANCE SERVICES
u 1.0'
SET DMA. Ite1 , E
0.50
M • D'
FD.PIPS
w.lt
•
t0.o•
4#60
11.0' •
PLAN OF SURVEY
10' ,.5 PI4 15�,ta
W°°o
N
ZS,35
0-A.14 T.L.
6'
1'1.4o'
r
Cil
N
Z.0 5'
t ST`S c. B.S.
(04-11/41.W. ttt CT
m
ISA° r ' 23.54'
75
. • .
•
N, ' r.
N •
3 1.12.'
0
J
Z8'Ci .&
ZZ.Oo' •
124.6 r
N
a�
1Z•
ZZ' pAvAl
///r" 57
f9
4
4.
c1. poLE
5e - r ?we
I. S'
t
Fes. P1
0 d
N
2 s