MECHANICALLegal Description
No
Ty -s to
My Commission E
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date r� i Job Address )6° % � 5t
Tax Folio // a
nn
,4444,/ifoys/
Ower / Lessee / Tenant
Owner's Address ,� G y CoContracting Co. ( , �i ,� 4 j Address 7 35) ° S r'
Qualifier 1 e f1 r�1� OCNZ:771._ 1� _ 2 && Phone �� 6 r
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): UILDING ELECTRICAL PL NG MECHANICAL FING PAVING FENCE SIGN
WORK D1BSC�IPTION C > k <-�/'1./D��e
/ /e , M �� / ?
Square Ft. Estimated Cost(value) ,1 / 71�� �—
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
NOT %CE 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 cons] action and zoning. Furthermore, I
authorize th above - named contractor to do the work stated
Signature oL owner and /or Condo President ' S natur of Contractor or Owner - Builder
Dane: / / /.S ate:/) N 6?
sue 4:9°7,4% l�SEIFR
Owner an • r e 44 i, y
Expires 'c o4 No.MOl
17?
My Commission Expires:
Master Permit
Phone
/17
V772;7-L._)
of ar a
s to Contractor or Owner - Builder
R R **
FEES: PERMIT 1 : l ' RADON C . C . F . 1.00 NOTARY , TOTAL DUE 6
Fire Other
Building Electrical
Plumbing Engineering
Date f, '< Job Address/_ )-'iL � � �f.! C Tax Folio /r�/
"
Legs Description �'- G g %✓
Square Ft.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Owner / Lessee / Tenant - Master Permit # �I
Owner's Address > %a-►(1
Contracting Co. jf/1/1 Address /A':
Qualifier �'�i;;> f L � f � SS# ` �
State l) 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 �, i:' L_ / / ,,/ ';�- -
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 ' L
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President Ndtary as to
My Commission Expires: My Commission
** * * * * * * * * * * * * * * *
FEES' PERMIT.) RADON C.C.F. 4 g NOTARY 4"/"P TOTAL DUE - % '' ;
APPROVED: Fire Other
Zoning
(Mechanical
Phone
Estimated Cost(value)
l'',li fu
Signa
Date:
/941 ontrar -for or Owner - Builder.
Building Electrical
Plumbing_ Engineering
**
e /
4
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