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1022 NE 91 Terr (3)Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 1. -3©'22 Time For Inspector: Sly_ 0 a Approved Correction Re- Insp'n Fee '46 444-zi /a zz. Ne q/ rcc 4- Vs lO 3s 7/2 I!A 1 - • ve AR;;Aft, MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date /-; "i2 Time Type Insp'n — 44 Permit No. (2 ,e6t- »' Name -564!1> Address /P4 / v b ff/ /' e.0 Company 17t t ,cif1c Phone # ®:� 3,5= /7e For Inspector: 9-9 2) Name & Date Approved 2� Correction ❑ Re -Insp' n Fee ❑ Type Insp'n Permit No. Name Address Company Phone # For Inspecto Approved ) 1i Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time fl� • 1, Legal description: Lot: • Applicant: Print Name: APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY ,/te (,( (re hereby apply for yrtificatey/reoccupy the single family residence known as: (address) 7 Z2 /1/ (- ( 7 , Miami Shores, Florida_ ,Block ,PB&PG: I hereby certify that I understand that the zoning of the property is for single- family residential use and that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re -Occupancy that may be issued by Mani Shores Village, Florida, certifies only that the referenced property is being used for single- F=1'1y purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on "cii pro city. Buyer Seller. Realtor. Company Application Fee (S50) Paid: Cash: Chedc N -6 Date: / ******************************** * * * * * * * * * * * * * * * * *m * * * * * * * * * * * ** For the purposes of conducting the inspection required by Section 902 of the Mani Shores Development and Zo}ing Code, co . 1 Contact Name: 7 i ne: 53/ X /K3 //Z. 447 7, / , Approved: I/ Denied: Daze: Inspection: By • � V Comments: ( J 1 ■ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 9 f 6. Job Address /b U- A 9 / r Tax Folio / Legal Description 3 ma 6 goo Fr of Gorz Historically Designated: Yes No 1 QLoC1C,2, WATEILSEDGE Owner/Lessee / Tenant -A M E S S. 4 1 GG ►N S Master Permit # Owner's Address 1 O LL ►J � , Q 1 TEE2Aire-E IA 1 A-M l $14002.LorS, fZ Phone C30 7 S7 - 9 9 f 9 Contracting Co. 1vt /A j/= Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one) BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 2EMOV�I-( A-ND R ecnce 'i r o-F S}4ED . (ui NUMJ Square Ft. ) 6 O Estimated Cost (value) /I 2.230. o 0 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 FEES: PERMIT /'io . RADON Notary as to Owner and/or Condo President Date My Commission Expires: My Commission Expires: L. o / anfr ctor X- der 9/2_3/9, Notary as to Contractor or Owner - Builder Date j C.C.F. /f J C) NOTARY TOTAL DUE 4 /6, APPROVED: L Cvk ?V5 ) Zoning Building � Electrical Mechanical Plumbing Engineering • • • CERTIFICATE OF RE- OCCUPANCY On behalf ofMlami Shores Village, Florida, the undersigned certifies that the property described in the application has been inspected for the purposes of re- occupancy pursuant to Sections 901 and 902 of the Miami Shores Land Development and Zoning Code and that such property may be re- occupied by the applicant for single - family residential purposes. MIAMI SHORES VILLAGE, FLORIDA By Date of Certification: THIS CERi'Lh'iCATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN LNSPECIED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENT CODE PERTAINING SOLELY TO rkiJ REQUIREMENT THAT EACH ONE - FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE- FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION, AND INTERESTED PARTIES ARE ADVISED AND ENCOURAGED TO MAKE UIEIR OWN INSPECTION OF THE PREMISES IN ORDER TO DETER L`IE 1HE CONDITION THEREOF. STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. a ,19..,2 Owner's Name and Address.u.'.°._i 141.1 c^v!4. M N - (' 4!1�• i 4—AT No.J®� 2 Street__. Id_T. riZAR, Registered Architect and /or Engineer Name and address of licensed contractor .S. EI` hi As C F{ ( J41 .2 _ .__7 Ri Date_ Location and legal description of lot to be built on: T t Lot C E.:_. Block 2 Subdivision 1 4.) Street and Number where work is to be done �la..�.�e.___IYc.�- ki.�T State work to be done and purpose of building (by floors) �`tc�_ 1 _.d- 1�[.°ll•� � Et T ,(�, 0 VT tL f) and for no other purpose. New Building Remodeling P Addition Repairs No. of Stories To be constructed of Kind of foundatig1' Roof Covering Estimated Total cost of improvements $ "p/iiii"/ /Oda, d °Amount of Permit $ ... � ,� Zone cubage required _Plan ;e Distance to next nearest building Size of Building Lot MaXiMUM live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may 1044.. oti, 04A44 '4444 be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, compliance an d has complied with the provisions thereof, and will require similar from all contractors or sub- contractors employed by him in the work to be performed tinder this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. red., Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared.__.__—_-- .._ __.__.____.. _.____ _ _-------- _..__._---------- •- - - -_ -- ____ -- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No._ 1 Date 1 � Read, Sworn to and Subscribed before me. Disapproved D (Signed) '.. Bu ding Inspector My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Chairman ...._....... Member Member Member Member ...... ..... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re - inspection fee of $1.00 will be charged when such re inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 1 0 00 • • = iv vv s I N r T ND E. IL rf.. ftl L-1.4 tV1 IV r P 137 1 ' .i25 SOUTH ELEttikaatt. v., g cn T MATZ .V r•A.1 1r 1uE nn E ;Sr F,I. E71! 473 4 STATE OF FLORIDA DEPARTMENT OF COMMUNITY AFFAIRS EMERGENCY MANAGEMENT • HOUSING AND COMMUNITY DEVELOPMENT • RESOURCE PLANNING AND MANAGEMENT LAWTON CHILES JAMES F. MURLEY Governor Secretary June 28, 1996 Mr. Lewis Hartley Robin Builders P O Box 1067 Lake Wales FL 33859 RE: 1996 -97 Annual Renewal Based on the 1994 -SBC's Manufacturer's I.D. Number: RBI -18 This Approval Expires June 30, 1997 Dear Mr. Hartley: It is my pleasure to inform you that the Department of Community Affairs has renewed Robin Builders. approval to manufacture, guard shacks, commercial /commerical storage buildings and residential utility storage sheds for installation throughout the State of Florida. This renewal is granted pursuant to inspection of your submitted plans which were found by this department and your inspection/plans review agency to be in compliance with the applicable codes. On site installation requirements are specifically and entirely reserved to local authorities. These requirements must be reasonable and uniformly applied the same as for conventional construction. A copy of this letter must be attached to the approved plans when making application for local building permits. FLORIDA KEYS AREA OF CRITICAL STATE CONCERN FIELD OFFICE 2796 Overseas Highway, Suite 212 Marathon, Florida 33050 -2227 Sincerely, 'Lawrence J rdan Planning Manager Codes and Standards Office LHJ:sc cc:FSC 2555 SHUMARD OAK BOULEVARD • TALLAHASSEE, FLORIDA 3 2399 -2 100 SOUTH FLORIDA RECOVERY OFFICE P.O. Box 4022 8600 N.W. 36th Street Miami, Florida 33159 -4022 GREEN SWAMI' AREA OF CRITICAL STATE CONCERN FIELD OFFICE 155 East Summerlin !Lwow, Florida 311130 -4641 MbUNDARY S U R V F U SCALE: 1" _ >e)' I• 1 1 0 N 9 ,? I ,PeW s O.c� F 9.& A a H k eZzi 01-i R510ENG to 22 • I ea. 7' e f�- • NOTES: - BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE - ELEVATIONS WHEN SHOWN ARE REFERRED TO ':. I I•'J L8 QG t v ct,- ne t.tf" N j 6 v F 1, P ,c1)' /z " JO g O� TEPRAC PS. THE NATIONAL FLOOD INSURANCE RATE MAP DATED O5.OZ-19 C(d, PUBUSHED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY DELINEATES , THE HEREIN DESCRIBED LAND TO BE SITUATED WITHIN Z0NE )G COMMUNITY NO 11°61 PANEL 0 SUFFIX_ PROPERTY ADDRESS '' l ( e - e 5 R A C E MIA -41 SHO r- - - EL. LEGAL DESCRIPTION LOT ' A OD THE- 1 +-i,G , Fsi:77" DF l.bT 2 SUBDIVISION \�AT�y?SF_f�G ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK ' OF THE PUBLIC RECORDS OF DA- OE- COUNTY, FLORIDA CERTIFIED TO: t o I I r2 li G�I�T 14: 17 I 1 � r N 1 170 zi l r� a7 zt, Ize Let LOCATION SKETCH SCALE: 1" = duo WE HEREBY CERTIFY: That the attcched BOUNDARY SURVEY of the above described property is true and correct to the best of n our direction, ground encroachments unless • knowledge and belief as recently surveyed under ou d ect on, also that there ere no above g ound ene oaehme is u s technical n r Pursucnt to Section • and meets the minimum te. col sta de ds set forth by the FLORIDA BOARD OF LANO.SURVEYORS. Pu suc t n t o 472.027 FLA. Statutes and Chapter 21H —H6 of Florida Administrative Code. Examination of the abstract of title will hove to be made to determine recorded instruments, if any, affecting the property. locution and identification of utilities end /or adjacent to the property were not secured os such information was not requested. Ownership is subject to opinion of title. James S. Higgins Bank Atlantic Ritter, Feinstein & Zaretsky Attorney's Title Insurance, Fund Jo Bonfffl & Ass®haaltes hico R egistered Land Surveyor, Sfote of Florida 9360 S.W. 72nd STREET, Suite 265 Miami, Florida 33173 (305) 598 -8383 FAX: 598 - 0023 JUAN J. 80NFILt • A -'.0 PROFESSIONAL D S' RVEY0 STATE OF FLORIDA DATE: C O 2O— q4 REVISION REVISION• CLIENT: ORDER NO. BLOCK AT PAGF 14J NO. 3179 c=14- 1487 r 0 z 0 z 0 H H N M u m H V C W W C U ` OOI:t i"�,�C,W Z <W C > 3 3 U 3 V V W C= e n u 11 a 11 u n e e is »33 cn 1 1! 5 1 5 11 0 11 1 00 e n n u o u u u ■ C W W SW d� �• CC CCC - Z 0 (U u_ O 0 V O O z m Z Z C C7 C C o. C C.LG L' 0 0 Z O V0°:ZC E lr OU Ju E000t;: 3Dg U - C uWUU t�SJJ � Z n it 11 a 11 n n, II a 11 . ,,; w -_zc �ao� = W W W WIC =JJ�-= U UU vi c ::<00666000 C C (� 0 0 1 5 V.J. KNEZEVICH. P.E. JOHN W KNEZEVICH. P E October 24, 1994 Mr. Harry Jordan Sheds America 9660 N.W. 77th Avenue Hialeah Gardens, Florida 33016 Re: Shed Soil Anchors Dear Mr. Jordan: Knezevich and Associates, Inc. has reviewed the 1994 South Florida Building Code, including its ASCE 7 -88 provisions and determined that the enclosed table may be used for soil anchors manufactured by Tie Down Engineering. These tables were prepared for sheds with maximum wall height of 7'. These tables are for helical, drive and patio slab, type anchors only. We...have enclosed Tie Down Engineering Dr. No. MHP -101, Helix anchor';-.Dr. No. MHP - 110 , Cross Drive rock anchor, and MHP -120 Patio ;Slab. or as acceptable reference drawings. • KNEZEVICH AND ASSOCIATES, INC. ENGINEERS • PLANNERS • PRODUCT TESTING Ki ezevich, P.E. I resistant cc: file an+ M('KFNA ()RIVE.. MIAMI SPQINGS. FLORI()A 33168 TELEPHONE 1305) 883.9571 FACSIMILE 1305) 883.9572 MODEL SIZE & ANCHOR SPACING SCHEDULE 10 18' 10' xZv' 10' w22,' i SIZE WIDTH V' = o x G' 0 4 ,1 x 4; 4 x G' 4' •.:.7" • 4 6' 41 - 0 " 4 lo' 4 =d" 4'X12' 4 5'x1' G'x0 G'• e0 . G t (#' 12' G'x14' id-o" b'x I ' 61.0" 11x4,1 -po 8'x 6'xlol 61x12' 31.40 ON 14' 0 6'x10 3 8►1 k • SO • {b' 6 =d G:oo • 6 =0 p +�pw G l-o 0 b go" g - BIx14.11 01. x 22' Si 6 ' x 24 ' • •'•p1• 101 lot to =o" 10' x 12' 1011" 10' x 14' lotol' 10 Iii' Id_4w 10 x14. 14 'It III 12' -0 12'x 14' 11'x 'GI 12' x 16 12'x 2 0' 11' x f2' I2' x24 K' -o" 12 12 12- " LENGTH 5 •r GI-o" 60- • CA. O M Iato" 12 1 = �Ow WI. or I ZLo" 1,4.L�0 to '••••• 10' -or 1 t +•p'' 12=0'' • 14' -•1' IG�r Ib=+" '4v %01 22'4► • Z„pt• r TOTAL. NO. OF SOIL ANCHORS 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 10i•M 4 1*-o* 10LO» 6 404j 24' -or t3 4 IL' -o" 6 I4:0„ 6 8.• 6 •ro 8 8 b • • • -^ • • • • Zr,. • • , f.: 1995 LTR. I DATE DESCRIPTION o-t-b2, REVISIONS tie down engineering, inc. s0('1 w+*OIo' Oti. An. G•aoa 3C »: TITLE .4AOCeLMI22A),m 1 / COUOL_ -NELIX = Af`7r1 ANCt 0R. RT / el. tiOAC.F1 CX. ET. C. M3ch4hVtCt-1 SCALE NONE OR. HO A,{ I r 101. IY \ R°Arili-) u T r.1 71GICA*7 p�P c1/4c- 3 116 n Paler._ LJeld • 1 041- d 4" J r:.00 A ct "ACq QT . �0 NOTE v D�P�GL MATERIAL SPECIFICATIONS HEAD - AISI•C10085pa. ROD - ASTM A - 36 MOD WELDING ELECTRODES . LINCOLN INNERSHIELD NR • 311, or EQUIV. BOLTS -ASTM A -307 ALTERNATE ANCHOR ROD • Y'.' DIAMETER (IF REQUIRED) ANCHOR FINISH - ENAMEL DIP or GALVANIZED OF REQUIRED) BOLT FINISH • ZINC PLATED - T1 =NSIO >ZOLIS r;MODL bISE) AN1= 0 x 2;4" ut=X HEAD \o/SQUANt N CY- 1(ZINC PLATED) NQ T5. - T[N5101i EOLT LABELED t`" FOP FRAMe ATTACpMEMT ONLY. - TENSIONbOLT LABELED '3 FOP VE ICALMNSION. 3 LT!. DATE OISCIIrrION p 7� 1 7_22 - tivisiONs tie down engineering, inc. y001 .......von 0 -r. .'..or0•oo = lb � ♦ 1 TITLI moceL- ckbsS calve RACK Pt R D!. BY K.NOACK Cz Sr C. MacKAR.VIC H fCA t NOtyt 01. NO MuP-110 iV 47 5 o `� '' 'pA X 46 7 OD D G�, R I � L R CIA LM � � 1 � S� j � .r� ° Ro 1 , 1 4,1 11' S T D A —�l s. INSTALLATION INSTRUCTIONS DRILL %" DIA. HOLE 51" DEEP FOR PILOT STUD. INSERT PILOT STUD INTO HOLE. DRILL 2 -3/4" DIA. HOLES IN ROCK AT 45 DEGREES ANGLES. USING ANCHOR HEAD AS A LOCATING GUIDE. PLACE ROD THROUGH TOP & CORRESPONDING BOTTOM WEB FLANGE & INTO HOLE. DRIVE ROD TO DESIRED DEPTH. (ROD MUST BE DRIVEN INTO ROCK AT LEAST 80% OF ITS LENGTH IN,' ORDER TO ACHIEVE MINIMUM ALLOWABLE PULLOUT RESIS- TANCE.) PLACE SECOND ROD THROUGH REMAINING TOP & CORRESPONDING BOTTOM WEB FLANGE & INTO HOLE. DRIVE ROD TO DESIRED DEPTH TO LOCK. MAXIMUM PULLOUT RESISTANCE IS DEVELOPED WHEN ANCHOR HEAD IS AS LOW AS POSSIBLE AND GROUND SURFACE IS SOLID ROCK. DISTANCE FROM LOWEST EDGE OF BOTTOM FLANGE TO ROCK SURFACE SHOULD NOT EXCEED 1" (INCH). o5S° j C P) " Z\�Gp�P 14 NZ.,-(4 b No `� 6 uN , yE 7.k. NOTE *7 I; . 'I M MATERIAL SPECIFICATIONS HEAD • AISI • C 1008 5 ga. RO0 • ASTM A • 36 MOD WELDING ELECTRODES • LINCOLN INNERSHIELD NR • 311. or ECUIV BOLTS - ASTMA•307 ALTERNATE ANCHOR ROD • 1 4 " DIAMETER (IF REOUIREDI ANCHOR FINISH • ENAMEL DIP or GALVANIZED OF REQUIRED) BOLT FINISH • ZINC PLATED — TENSION ['twoL"TS (MODEL anti) ARE - 3/80. 11 x 2 4." L. HEX HEAD Lo/SOuARE NECK (21NC PLATED) uJ /N errs . — TENSION (OLT LABELED ® FOR FRAME ATTI CI- INTENT or, — TENSION COLT LABELED FOR VERTICAL TENS\ bN. LTI. DATE I DESCRIPTION 1 8 - 82 1 REVISIONS tie down engineering, inc 5901 YNrpro,. .... Avonid G.aQO 30110 TITLE MODO'. MIC52 PATIO SLAB LNC.FOR' tXPAHSO1 -1 CIT 0I. IT V.I.KO C.1 CX. IT. C. M3cnANVICi; SCALE NONE DI. NO mk 20 p _PdYl w1E►.1 T I N I T k e d CI No Q s liV rs p �Fs d =r 7/b C I S. c1 GxP Fr �, 1 i�INx- ,g'L' x j PEEP ;SOLE FIEQUINED IN SLAb MATERIAL SPECIFICATIONS HEAD •AISI•C10085ga ROD • ASTM A • 76 MC0 WELDING ELECTRODES • LINCOLN INNERSHIELD NR • 3u. or EOUIV BOLTS • ASTM A • 307 ALTERNATE ANCHOR ROD • 31- DIAMETER (IF REOUIREDI ANCHOR FINISH • ENAMEL DIP Or GALVANIZED (IF REOUIRED) BOLT FINISH • ZINC PLATED 9. '4 L . s GA .00 0 ) s NOTE --- -INC P LA T L- INSTALLATION INSTRUCTIONS DRILL %" x 3" HOLE. PLACE STEEEL EXPANSION SLEEVE OVER BOLT & PLACE INTO HOLE. PLACE WASHER OVER TIP OF EXPANSION BOLT. THREAD NUT ON10 EXPANSION BOLT & TIGHTEN NUT UNTIL MAXIMUM EXPANSION OF STEEL EXPANSION SLEEVE HAS BEEN ACHIEVED. REMOVE NUT & WASHER. PLACE WASHER OVER EXTRUDING TIP OF EXPANSION BOLT & TIGHTEN NUT. NOTE: CONCRETE TO BE 2500 PSI MIN. SLAB TO BE 4" MIN. THICKNESS WITH 6/6 x 10-10 WIRE MESH. CONCRETE SLAB SIZE TO ALLOW 4750 LBS. VERTICAL TENSION ON ANCHOR WITHOUT LIFTING SLAB. ASSUME CON- CRETE WT. OF 150 LBS. /CU FT. - T1 =NSION EDLTS (MODCL b I5b) A.NE -11 ' 1-1 CX -1EAD /SQUANE NECh(ZINC PLATED) -/N < T5. TCNS101'i COLT LA5CLED FOP, F .4ME An ONLY. - TeNS1ON ItOLT LABELED FOP - Vi=P,TICAL T NStON. 1 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 54 • Job Address 10079Z tf 9(' Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant £u7':y C L5 NTO,J . Master Permit # i 6 Owner's Address / QQ? oZ /`-1 e 9/J . A Phone 305 9-1/45 6N0F 9 Contracting Co. O Address Qualifier SS# Phone 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 Q /0 n 2- C Q. 4:1C4.19—k, c a.,6 vulf 6,/ift JOOd 0/u2.5 - / ad (CGf (0 oral / OC.ci Square Ft. / 0 OC7 Estimated Cost (value) 000 r 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. wner and/or Condo President FEES: PERMIT 70 RADON Date Notary as to Owner and/or Condo President Date My Commission Expires: e of Contra or or Owne - Builder d 3ate .►., ►' ! ..i' as t . ' Contract . or y Commission Expi es: Electrical er -B ilder • o � p RY Po e/ OFFICIAL " O i i RY SEAL ANGELA M BECKER •�' n OAetxss*ON MU Era c CC786697 - ci aay COMMISSION EXPIRES b �~ oF4.O NOV. i :: O2 b NOTARY& 0 0 BOND ate iv TOTAL DUE 7 7 APPROVED: Zoning Building 4 )eil)( K Mechanical Plumbing Structural Engineer ,____§. STave • OM T• 1 Ce/x RAJ f - 5 /Al • CA6 NeTS H ' 0 c�u (A ca. rev '/ eel ce, Ca.0 wa . Na c e 6 e.r1(-/i cl6ri- .