1100 NE 91 Terr (3)PERMIT APPLICATION,FO,R,MUNICIPALITIE$ OF DADE COUNTY
(OWNER TO RETAIN COPY)
QTY HALL OF MIAMI SHORES, FLORIDA.
Date 2/17/93 Job Address 1100 N.E. 91 TERRACE Tax Folio '3 d 60/_ T, °° 9 ?
6
Legal Description .. 11 ' 44/7;
Owner / Lessee / Tenant
Qualifier SEYMOUR GOTHELF-
WORK DESCRIPTION REPLACING 6 D H WITH 6 S H AS PER CONT
Square Ft. 78 :07
# 5290 FOR THE INSTALLATION.
Signature o +` er and /or Condo President
Date:
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APPROVED:
Notary as to Owner and /or Condo President
My Commission Expires:
Fire
Zoning
ignature of
Date:
N/
Master Permit ##
Owner's Address //c , /.ti 9/ At) Phone
NORTH MIAMI BEACH, FLORIDA
SEYMOUR GOTHELF-
Contractin Co Address 1 7.1 ILE .Zrh_aLACF
SS ## - - Phone
State ## CBC 9454 Municipal # Competency ## Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOPING PAVING PENCE SIGN
•1 TG_ •
Estimated Cost(value) 1,150.00
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, ROOPING 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 t. above -name ontractor to do the work stated
Other
ntractor or Owner - Builder
, ) - /I 7/4 )
Notary as to Contractor or Owner- Builder
My Commission Expires:
** * * * / * * * * s * * * * * * * **
PEES: PERMIT leb`' / RADON C.C.F. /V 0 NOTARY TOTAL DUE A5
Electrical
Mechanical Plumbing Engineering