1053 NE 91 Terr (3)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address 10 53 / V A� k 9 /rj Tax Folio 1/ 'rt 4 :4 /.'4 .-,
Legal Description ) / AJ ; tj Master Permit # ,_;';; /
Owner / Lessee / Tenant I) &N 1 El i
C9
Owner's Address
Contracting C
Qualifier cross"
State#
Architect /Engineer
Bonding Company
Mortgagor
Square Ft.
PERMIT FEE: APPROVED:
5
phone g'7 6 Y
- oP,e /l / Address 9 ° IC LA/ G9 i9ifl5 f Q 1 'l1
3 if) 0.6
Permit Type (circle one lo6UILDIN' ELECTRICAL
WORK DESCRIPTION /U y}-l A- CAA) S p, -i 1 S I' S c i -S cu/cdi
cUrtGc
/7 00
Signature of Owner and /or Condo President
Date:
Notary as to Owner and /or - Cor do. President^
My Commission Expires:
* * * *
C 1 CTf ss# Phone t4 ! 6 6 5
Competency is 00 /)-67(57? Ins. Co. / 4 %r;;
Address
Address
Address
Fire
PLUMBING
MECHANICAL
rr v
PAVING
FENCE
Estimated Cost i 50 0
SIGN
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. 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, authorize the above -named contractor to do the work stated.
No- ary /as to Contractor or Owner - B uilder
My Commission Expires: aoa�t °� J�IC se a m rLO�a�aa
EY C0: -,'t ; I SSI�7Pd E7,= g��fA:2.23,1p9<
* * * * D0:'DED Ormi ,FNEA.
f rp� Other
l
Zoning Building `OJ Electrical
Mechanical Plumbing Engineering
Signa u of Contractor or Owner - Builder
Date. � � -
0 9 9 ?
'ERMIT # • Tax Folio No. f/ f Z o< ,/ Sf
,tats of Florida
ounty of Dade
HE UNDERSIGNED hereby gives notice that improvement will be made to certain real
roperty, and in accordance with Chapter 713, Florida Statutes, the following
nformation is provided in this Notice of Commencement.
. Description of property: (legal description of the property, and street address if
available) it/ /
. General description of improvement: 1f
▪ Owner i n f o r m a t i o n : _ 'Tlun 1053 NE ' I M
Tema' N IQA( re..,, i. 33r: a. Name and. Address: �Di U/
� -1 J
b. Interest in property: 1 ■QIe kids4nCC
c. Name and address of fee simple titleholder(if other than owner):
Contractor:
. Surety:
a. Name and Address
b. Amount of bond$
toss NE '91 2 1rp'4ce M amp 6xye5 Pc 3 3 ( 35
P re r ,ec¢
a
1_j, c
(name and [ P c address) (O t R
. Lender: (name and address) K0/• 6 " We
Persons with the State of Florida designated by Owner upon . whom notices or
other documents may be served as provided by Section 713.13(1)(a)7., Florida
Statutes: (name and address)
In addition to himself, Owner designates _ of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),
Florida Statutes.
STATL Cs H.O Zn
• c goipir date
1 : Y CERTI'rY iwit do E3 0
on . �l ° tt 1 6rP 0
r. , A. D.
Wl D -S my hard and / ficial Scol.
4
:• G
Clark Circuit
<- \ E/ Signature of Own
•.iorn to and d before me this r� day of �/Qj7GC i
lta` / "ublic
of ,noti ` N`• il., mencement (the expiration date is 1 year from
, CUIT Apo C ✓�
J ;.ess ` t!''fferent date is specified)
- �
NOTICE OF COMMENCEMENT
won
NOTARY PUBLIC, STATE OF FLORIDA. (
elor
COMMISSION N NOTARY rum(' i J uue 23, 1995.
My Comm i s sion Expires �ZTTCSs
1
92R008908 1992 JAN ('9 11:55
995 Std (09+
Kam; , FL 3314 4.
rrgo S. UIxIQ Hy, -it «o4 Cc)(cQ Gpllis Ft
314f
, 1 97 2 E, •