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9600 NE 2 Ave (10)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address J Yf ,V• , E' tTax Folio Date Legal Description Historically Designated: Yes Owner/Lessee / Tenant V �AI 1 .- 4 80 /e Owner's Address j2 /1/ E C tr tin C o. /'' E 1 C '1` c 1 4-14 c r Address on ac No Master Permit # p� j /5 Phone l 06 (1) E. 1 s SS# ' 3 73 State # ( d d t) ;657? S Municipal # Competency # Ins. Co. 4 ( S if 46 Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUIL WORK DESCRIPTION ELECTRICAL P vt a r. Re vu 6uti s Square Ft. MBING MECHANICAL ROOFING PAVING FENCE SIGN 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 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 - . es contractor to do the work stated. Signature of owner and/or Condo Pre : -nt Date Notary as to er and/or Condo President Date Notary as to Contractor or Owner- Builder Date My Co ssion Expires: My Commission Expires: FEES: PERMIT 3.s ` C.0© RADON APPROVED: Zoning Mechanical Signature of Contractor or Owner- Builder C.C.F. NOTARY • TOTAL DUE , Date Building Electrical.') Plumbing Engineering Date v M Job Address /79 1 Owner / Lessee / Tenant J' Y4 Master Permit # 3 g_ Owner's Address /79 A"g 9 j /1` J W3- Phone Contracting Co. 7c Qualifier 22 State # A 74iunicipal # Competency # Legal Description Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): ILDING PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION r at-- 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 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 constructi -,n and zoning. Fu thermore, I author the above -named contractor to do the work stated. 141 Sign ure of owner f or Date: 45.psY wkt,,, _ l t Notary as to Owne T 4:4r W My Commission Expired: ** * * * * FEES: PERMIT " APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE c esig(gnt 0 ROBLES fission Expires e 4, 1996 Pr i SS# / 4 g ent Address * * RADON C.C.F. a 15e" Zoning Mechanical Fire Other Building Plumbing_ Tax Folio 02406)-,‘ //r Signature of Contrac Date: `l ; * +. * e° err ' " E P ": My Notary $s ;:•nJract " , e . My Con miXta. ion pbnesrt. No. CC 205953 .rr+ * * * Ins.Co. NOTARY TOTAL DUE J" Electrical Engineering er- Builder