PL-03-6Date
PERMIT APPLICATIoNiiii IAMB SHORES VILLAGE •
ipoitrz. Job Address I I 30C) (V% 4tY Q' .Tax Folio
LAO
�y �� or idiI ' I to Yes No
• • • • • • • • • •
• • • .
uk U{ji✓ el( S;'+ • • • • • • • • • • Master Permit # () 1 2002, 0 ? J g - 1'3
Owner/l:essee / Tenant
Owner's Address �J (5 0 Lib Y + tvN. r0-Y;" : € Y'-P', • • • • Phone •
Contracting C o . i G P 1 � v 0, i U r • •. • : • A c t r e s s . . : 1 3 a.°) f - 0300 9.beL.4
Qualifier 0. e SS# Phone (51) LIQ3 -015b
State # !" t / . Municipal # v 1 w / Dade Competency # G D 2O Ins. Co.
Architect/Engineer - Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
- WORK DESCRIPTION PUM 8. l.) G ouch PO r 11- U IJ i t}' i
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 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.P.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.
19lt010 a
Signature of owner and/or Condo President Date Signa of Co ctor or O der Date
Notary as to Owner and/or Condo President Date Notary : • n �� lal (01001 lO(01001 or • : udder Date
My Commission Expires: My Commission A'
a.• tiiitlArN[ir TKRAL
DAISYDIAZ
NOTARY PUBIIC STATE OF FLORIDA
COMMISSION NO. CC900460
MY COMMISSION EXP. JAN. 6,2004
t!/
X 6 00
FEES: PERMIT 5J RADON
APPROVED:
Zoning Building
Mechanical Plumbing
Electrical
n - O CR
Structural Engineer
Miami Shores Villa
e 9
10050 NE 2nd Avenue
-
Phone: 305-795-2204
Printed: 1/15/2003
Applicant: BARRY UNIVERSITY
Owner: STUDENT UNION
JOB ADDRESS: 11300
Contractor RIGHT WAY PLUMBING CO INC
Local Phone:
Parcel # 1121360000040
If there is no permit pa ---
fee is $50.00, which mus
This Permit is granted to the o
ordinances pertaining thereto anc
and approved by the proper m
authorization. A further condi on
ordinances an• egul -f ns Berta
by his agen ��- a rr` or / plc)!
In consid n of e issuana
with the plans, drawings, statemE
/myself, my agent, servants or err
Signed:
PAY
TO THE
ORDER
OF
N MIAMI
Legal Description:
CITY OF MIAMI SHORES VILLAGE
Plumbing Permit
Permit Number: PL2003 -6
4tGe-uiD cuAS
STUDENT UNION
BARRY UNIVERSITY
AVE
Page 1 of 1
Contractor's Address: DOING BUS IN DADE CO
p 2.&yrs,Jt 55 a 0
Total Fees: $D
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 7/14/2003 Construction Value$370,
Work: PLUMBING ROUGH FOR STUDENT UNION
RIGHT WAY PLUMBING COMPANY
1329 SHOTGUN ROAD
SUNRISE, FL 33326 -1935
PH (800) 921 -9289
WACHOVIA BANK, N.A.
WESTON, FL 33331
63- 1356/670 04037
DATE
12/06/02
44d114 o u/_
00
7
21663
NOT VALID AFTER 120 DAYS
21663
AMOUNT .
s/ SS 0.00
1