43423PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address //300 /W al nd f I'/6 Tax Folio
Legal Description Historically Designated: Yes No
/
'�/ Nl Owner/Lessee / Tenant &a" VG S / Master Permit # 2 1� �
Owners Address / /a7 O d N �l'�/(:— Phone ,,�L 1 ,
Contracting Co. FLO/Z /v,7 2 V17Z�1-f+ er &POP Address 423. o5' ' /3.2 'z/`�'�
I Cr
Qualifier ) •,Ofdai 44t/ ._& - . Phone 049 — �r r
WORK DESCRIPTION
Signature of owner and/or Condo President Date
FEES: PERMIT
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
& 1/0/CEAW er-Ari.475
Square Ft. Estimated Cost (value) 4 14 1, 4 1 0a
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 FI ECTRICAL, 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.
C.C.F.
Signature of Contractor or Owner -Build
0 111-41IL-
Notary as to Owner and/or Condo President Date Notar'I as to Contractor or Owner- Builder
My Commission Expires:
MY Commission Expi nv.a ,k , a, v,
SHAY " °B t . Rhonda G. Mitchell
"6 Notary Public, State of Florida
a , o f Commission No. CC 6651
4. 0F R My C ion pm.
1-800-3- NOTARY - Fla. Navy Scwice & Borg Co. ' <
Date
(0 405 9
Date
NOTARY BOND
TOTAL DUE 5
APPROVED:
7iming Building Electric
Mechanical Plumbing Engineering
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Legal
Description
Address of
Building
U L L ITLJ
Contractor `
or Builder 10 r T7 ra_a T o
Lot
BI
c l g.13 Nse 2Aire. r
CONTRACTOR or BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in st et compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, tatements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if th, work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whethe • wn on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants tr em to
Signed. • - �� INSPECTOR) BY
In consideration of the issuance to me o this permit I agree' to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this pewit I assume responsibility for all work done by either, myself, my agent, servant or employee.
N_ 43423
Work to be performed under this Permit
Date
i •
6-' .97g
Contractor's
cow 171
License No.
m.itat a 34 r vvzeg, Gam,
de-14 44:4
CCIT : Z. OD
Subdi p. /L BOND:
vision D — 00 /t' PhDON:
Sq Ft
Value of 11 Amount of / o • Q o
Project $ 4I � 11 Permit $ f 10
BY AUTHORITY
er` 18 '98 11:15
II'
NOTICE OF COMMENCEMENT
PERMIT NO. 4 3 4-
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that Improvements will be made to certain real property, and In accordanc6 with
Chaplet 713. Florida Statutes. the following information is provided In this Notice of Commencement.
1. Legal description of property and street address:
2. Description of Improvement:
3: Owner(a) name and address:
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
5. Surety:(Payment bond requiredpy owner from contractor, If any)
Name and address: /L/ A
Amount of bond $ 11
6. Lender's name and address: .4//4
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1),(a)7., Florida Statutes.
Name and address:
8. In addition to himself. Owner designates the following person(s) to receive a copy of the Uenor's Notice as provided In Sec-
tion 713.13(1)(b). Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different dale is specified) h' ; 24 r , G,
8 c
uvuft r 61
Sworn to and subscribed before me $ day of 1�Lt0 19 go.
S • Nature 01 : net
/13 r>f, p J iF d 1 ., va_
Notary Public
My Commission Expires:
tefiA
TAX FOLIO NO.
M)Arn1, P1
STATE OF FLORIDA, COUNTY O,Q4)ADE
1 HESE,Y CERTIFY I:'o' this Is o frovvolliif the
e Il.nu'r:loi In iS ogles nn day of
...
, A O 19
FAX P. 1 °
'letII Seal.
w TNt'S :n9 It •.1
tr CLERK, ��, n
'' • rte
nl
98R4-19n29 1998 AUG 25 15:07
wewomvommims««tamsw.s.vmst«t
> vi � Rhonda G. Mitchell
e
• ' Notary Public, State of Florida
if Commission No. CC 655297
s or tt ° My Commission Exp. 06/12/2001
1- soo•3.NOTARY - Fit Navy Service & Bowfin; Co.
.
Rh„, ,,,) G. ,M 'F� e!/ I
1a3Sv SIw i 0 ` ik'-i
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