45295Date IT
Legal Description
Owner see / Tenant
S' tare of owner and/or
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
A7S 1r4 3 .Mas d ICAk° 054.
Job Address 1/300 ,VE a. 4a Tax Folio
r rt. / (4, vers. "7✓' (1>f
Master Permit # Wet
Owner's Address //3 0 ,116 oZ 14 4t
Contractin Co. /7ri cl 4 ..Z;744.1 o f e/o .4 .2 i C
Qualifier / Z u vQ &2/a,,
State # e — 00Lsp /7 9
SS# / Phone 3bS 2 J
Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Adder
Mortgagor Address
Permit Type (circle one): BUILDING // � LECTRICA PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION "°, 3 / h.?' CS , %� �Q�'�'7.� .
Square Ft. Estimated Cost (value)
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 MINDER
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 ELF.CTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNERS 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.
Notary as to Owner and/or Condo President Date
My Commission xpires:
1 7///3/ 0 1019*,
APPROVED:
Zoning Building
Mechanical
Historically Designated: Yes No
4L3V 3
Phone 30 ,S - -3
Address /2 3 - o S kJ 1302 aeC7L /1
a
K s•
Signature of Contractor or a '
.
Nol.
My
Q()
Plumbing Structural Engineer
0... ..I1
or Owner -B . ti
Tres: .
1,4 ta
.,:.^,+:9•T• r OIku
TOTAL DUE
o �3
Date
•
(AY APPL_IC.t =CN TOR 3UILDING ?EMMEET HUTTUMUEEUNTIMIS ADDENDUM. I:' A LUSTER PERMIT ELS 3.
03 TA.IYED , _._ OW::..?' S NOTAP SIMIATURZ NJ NOT BE PRESENT ON Su3S3 L TT APPLICA IONS . )
1 MI
3AiH TIE
310ET
EI !ShYIASHER
0ISPCSAL
OR INK FOUNTA
FLCCR GRA
GREASE TRAP
INTSICVTOR
L.AVATCRY
u
SHOWER
PLUMBING
TRAY
CLOTHES WASHER
SINK. POT/3 Cam. 1 f 10TORS OVER 3- 5 IP
SINK. RESIOEWE
SINK. MCP
TEIFQRARY WATER cLosET
URI NAL
WATER CLOSET
IN3IRECT NAST'S
WATER SIPPLY TO:
A/C UNIT
F IRE SPR INKLS
HEATER-NEW INST.
HEATER- REPLAC
LAM SPRINKLER -4Rt1
S7I JIM ING POOL
WATER say IC
SUER CON ECTIONS
UT IL ITY -SEDER
UT IL ITY- NEATER
SEPTIC TANK
ORAINFIELD. 4 TILE/RES.
0ISC- tAR,GE WELL
DOIEST IC
AREA GRAIN
ROOF INLET
P00L P IPING
GAS RANI
IrETER SET
GAS PIP ITG
IIELL
SOLAR RATER HEATER
FIRE STANCP!PE
LAW SPRINKLER SYSTEM
(GAS)
_.._ ruUA TO BULL! NG PERMIT APPLICATION
±ON
S7IfTO.1 CURES
1 LIGfT CUTLETS
I REt PTACLES
SERV la TEPCRARY
SERVICE SIZE IN APPS
SERVICE REPAIRAETE O W&c
APPL INCE CUTLETS
RAN3E TOP
OVB
RATER HEATER
10TORS 0- 1 If
10TCRS OVER 1- 31?
10TCRS OVER 5- 8 If
113T(TRS OVER 8- 10 If
10TCRS OVER 10- 2 1P
1GTCRS OVER 25-103 1f
10T1RS OVER 100 FP
A/C IIIC0
AIR 020IT101ERS
STRIP HEATER
SEiERATCRS TIROL
GE ROTORS Buitsmass
6ENS1AT73RS TRAI6FORtIERS
SPECIAL R. POSE
CUTLETS Cf1ERC1AL
SIU31 TtEES
SIGN TRAGFCRISS
S1GV TI1E a a
FIXT(AES
MEM
RELAY TELEVISION CUTLETS
VIOLATION
PUP & ABANDON S 1C TARO( RE INSPECTION
SOAKAGE PIT CU. rr . Th CO Le
CATCH 8ASIN
ELECTRICAL/% MECHANICAL
"Paon_10 D U L r
AV-675 WIN
UNIT I FE `E
ITBI
SPAC I€A
!N1BAL HEAT MG
A/C (Z1DC)
A/C (C ITRAL)
MUT 100(
BUR
PRESS AND PRESS PIPING
18+ TAWS
ABOVE MOO TONICS
U.F. PRESSL E VESSELS
STEAM 1301I.ERS
TOT WATER BOILERS
1EG'IANICAL VENTILATION
TRANSPCERTING ASSEL
ELEVAT1RS/ESC LATC RS
FIRE SPR118Q FR STSTB S
C luE TOTTERS
VIOLATION
REINS?ECTION
Miff
FEE
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date - / Job Address / / Ng cryd46 Tax Folio
Legal Description Flistorically Designated: Yes No
Owner/Lessee / Tenant /5 C / n VG ' / s / 7y Master Permit # �/` 3 �.-
/ Phone
Contracting Co. FLf / AW „ ' - / f-//6r 6 Address 4.23570 05*T /3.2 Cr *., /
Qualifier t ot i mV SS# -( - Phone OD c) fryli
O w n e r ' s A d d r e s s / / 3 N c- AV C=
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
WORK DESCRIPTION - /Y.57/JLG X39 wick /APV C.004 :5
Square Ft. Estimated Cost (value)'4ODa
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 zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date
6 9
Notary as to Owner and/or Condo President Date No as to Contr ctor or Owner-Builder
Date
My Commission Expires: My Commission cCti
Expir , ; ,�� Q�� wti<<,kS��.ti��S��ti`sc"
' � Z
Pu Rhonda G. Mitchell
0 Notary Public, State of Florida
i; Commission No. CC 655297
4 'or n . e My Commission Exp. 06/12/2001
1400 • Fla Notary Service & Bonding Co.
? eeeeeuuu eetere ruauyeerarrarurauar
C.C.F. -/ • NOTARY U "
FEES: PERMIT
RADON
Date
BOND
TOTAL DUE 5 6--
APPROVED:
Zoning Building Electri .2
Mechanical Plumbing Engineering
d '98 11:15
NOTICE OF COMMENCEMENT
PERMIT NO. 43+-2
'
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice That Improvements will be made to certain real property, and In accordance ••ith
Chapler,713, Florida 8latutes. the following Information is provided In this Notice of Commencement.
1. Legal description of property and street address:
/ /3 rxr> P I !ti i 4 v - /YI I ,a rn / , P1
2. Description of Improvement:
3. Owners) name and address:
Interest in property: -
Name and address of lea simple titleholder:
TAX FOLIO NO.
FAX
4. Contractor's name and address:
/ G7
5. Sureiy:(Payment bond required owner from contractor, If any)
Name and address: /(-/
Amount of bond S
6. Lender's rtarne and address: .AJ`,4
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 7 13.13(1)(9)7.. Florida Statutes.
Name and address:
8. In addition to himself. Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Sec-
tion 713.13(1)(b). Florida Statutes.
Name and address:
9. Expiration dale of this Notice of Commencement: (the explralion date Is 1 year from the date of recording unless a
different date Is specified) _ ' „ • c; r r,,
s
name et a me
Sworn to and subscribed before me
Notary Public
My Commission Expires:
STATE OF rt ORIOA, COUNTY Q t)AUE
11IE!E9Y CERItFY I:+o' ilrh It o r"v:\ ce,rtr'or Ibe
11.no'f :1•4 In Is pitta nn I CJ o , .
A O 19
W Tr4ESS my 1, .4 , .d C( /'Icf'il Sad.
P.C.
b'v d 6
9884 19029 1991; AUG 25 15:07
SFr °4 s , Rhonda (1. Mitchell
f" Notary Public, State of Florida ;
Fit .' Commission No. CC 655297
opn.t My Commission Exp. 06/12/2001
1.1003•NOTARV • rte. Nowt' Service & Deadfall Ce. SS,
ee eeeeettreeeeete rttte(e e(eeeee yrr ,weeeeeea
R11vr'i& G. i t4 i - t !
123So S1w 1 30 2 l{Lj
331s,
P. I •