1100 NE 91 Terr (4)Dated ` Job Address ' 0.
Legal Description L -a
Owner / Lessee / Tenant
Owner's Address
Contracting Co.
Qualifier � ra
ca
Stag # unicipal # >" 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
Square Ft. g
Signatu cf owner and /or Condo President
Date:
M
77--a3- o7 er t id /or Condo President y
glail ; , a 4
NZ COMM:2M a=„7. AIM L- rre;,au "`:t `,i; r\L° VS. 'Olga
* * * * * * *
FEES: PERMIT t
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
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SS# - - Phone A
Phone
1
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RADON C.C.F.
Fire
Zoning Buildin
" Tax Folio B < ' &
Address k
Estimated Cost(value) i
Master Permit
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO FLAY 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
autho4ze th b•• named contractor to do the work staed.
f Contractor or Owner- Bui_.dar
Notary as to Contractor or Owner - Builder
My Commissi910iFAF9fitt;C STATE OF FLORIDA
MY COMMISSION EXP. JUNE 6,1995
* * *
BONDED THRU ERAL INS. UNt
* * GEN *
NOTARY TOTAL DUE / fl
**
Other
C Electrical
Mechanical Plumbing Engineering
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GOCAT /ON SKETCH
found 1/2' pipe
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found nail
28' Pavemerft
5.5' Grass area
5' Sidewalk.
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tility Pole
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of Sec P on
5-53-12 .
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REVISED
Il sr
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12888 S.W. 53rd ST.
SCALE: 1" = 20
DATE: 7— 269 70
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.xw# L /,, Gov . Sec 55
Lc,t 1_, c_d( the W.J.: t :/L of
LEGAL DESCRIPTION: Lot____- ii_ _ y _ Block_
Subdivision I; S FDC1
according to the Plat thereof as Recorder ■• Ptct Book
at Page 1 of the Public Records of uu <s' e.
SURVEY FOR: NANCY STEVENS
1100 NE 91 .'err,:cc, Miami 5horeL r _uric..
I HEREBY CERTIFY: That this 'SKETCH OF SURVEY" of the property described her n is true and
correct to the best of my knowledge and beiief as recently surveyd and drawn
under my supervision. This survey complies with the Minimum Technical
Standards adopted by the Florida State card of Land Suveyors pursuant to
t:1- ,, �; : Chapter 21 HH -6, Florida Administrativ Code.
I:, A ; . t. Iv ' i .:. l� .: 4 r i D { T, SUR IEYQRS. INC.
ri.,, weTJ SHOWN it L'i ,.r S v .:•\N r . ' j
.:.SS �� :.Rla)1A�, By: { .., s 3 Pres.
. _ i... J.i. K1SLN..': l7U t: . c6Ac-L
Waldo F. Paez `
Cif∎ .; . 1 i. , . , - C C E S S O i=: S !Th D/ �t :. ., . - ., • Registered Land Surveyor, 1\10..„;,,284
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. _ • _...:, -ir;.\:,r:A,i.I, . • .�.S �.. State of Florida
Note: Not Valid unless sealed with embossed Land Surveyor's Seal
DELTA SURVEYORS, INC.
County. Florida
LAND SURVEYORS LAND PLANNERS
PHONE: 223 -9907 MIAMI. FLORIDA
APPROVED BY:
PAEZ
SKETCH OF SURVEY
DRAWN BY: A . R•
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DRAWING NUMBER
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Residence No.1100
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