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1205 NE 91 Terr (2)
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address /RA's NC 7/ r iL Tax Folio Legal i . 'ption / 'O 5 Ale 7/ L Historically Designated: Yes No Owner/Lessee / Tenant 1.,/,1>/t9 .. ■ 4 4A/D0! /JL /,fibs 5,INDA/©L Master Permit # 4/0 ere o5 9 s� Date /U�>4M �3(3S' / �e> teQ. Ac S } Phone 6 761 7F Ee, (. �t c 'Address //3 S t h/l ' 7 , f y � ss# Phone (.4 ) 5/2 — J 9,f /( Ins. Co. Der eii17/Te Z� `/ t 2q c) TAM /44r � 1 Ase,` !l i Pc-trr G444a CI4 F'- P 1 e, 3 y/ Slo W 4601 / 611/0 Owner's Address Contracting Co. Qualifier L •41 D 0"I 1 a e-L State # ca a 5 g 7a-o°0 Municipal # 4 o€.- Architect/Engineer Bonding Company A/ Mortgagor C/y45 Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCEVIW WORK DESCRIPTION , /GgCe ))4414O /)/L W/1 // / /eP1. e. 1).444467e0 OA P r /3/4/,' y Square Ft. 4 6/0 — "" (O 5 er' Per WARNING TO OWNER: YOU MUST =CORD A NO ICE 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 re lating construction g. Furthermore authorize the above-named contractor to do the k stat owner and/o o President on o Pre 'gnat APPROVED: Zoning Mechanical dent Notary as to Owner and/or My Commission Expires: L (Y- �c, 7 SS3 i : CSD Skze L! lC iti:Y47 CC'%;323C5 ;'3l,luit 2, •iC37 u.iJ ' ai f :414 dui .Y linizrh$li ,3 FEES: PERMIT RADON C.C.F. Building Plumbing y� Competency # Address Address Address Estimated Cost (value) at ' Signature of Contractor or Owner Date Notary as to ontractor or Own -Ruilc My Commission Expires: odo 4 4'°/ c CAROLYN L. MARSHALL Notary Public, State of Florida My Comm. Exp. 5.09.97 Comm. No. CC 338242 NOTARY Electrical BOND TOTAL DUE S;id Engineering NOTICE OF COMMENCEMENT PERMIT NO. TAX FOLIO NO. a1 5 00 Li3 STATE OF FLORIDA: COUNTY OF DADE: w r- o a 1. Legal description of property and street address- ' I Ski Q, _9.4 . 2. Description of improvement: k3 {t �4 PA (� C £ f L f,U ( Al�lm ‘� Tft l Cflt2d7�T 11CPL CC.N141a) i V 'i 3. Owner(s) name and address: 1 9 I T f/ ' -` �` -►-�-, S k oc-es THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. Interest in property: - t - 01.a 4 0-7 Name and address of fee simple titleholder: 4. Contractor's name and address: A f& b >J� T �j - 1 E it Ce) no- 3 5 4 / Qr I ErL RAGG CA b2PrL FL 339,571 5. Surety:(Payment bond required by y owner ro contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within 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: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) gna Prin !Owner wners Name Sig-n 0 A � t1�ff Sworn to and subscribed efore me this 3 day of i ii u Agit 19 9 9 . OFFICIAL NOTARY s SHIRLEY J WALKER NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC351835 MY COMMISSION EXP. MAR. 18,1958 Notary Public _ ✓ }� Print Notary's Name S\N 1Q1 4_ My Commission Expires: 0 3- 16 - q r rJ Prepared by: L Address: t Zo6 NE Q/ - ' PERMIT NO. TAX FOLIO NO. ` t3 0 5 0,0/ STATE OF FLORIDA: COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street address R 0lg/t 4/ 0-7 6 " / - a 2. Description of improvement: . W Pt f l Y c 'PA I V. C £ / t_ c A a p£. -r- C i L c M 3.Owner(s) name and address: I aC ci I �� `� M ~ �•� ; ' k Interest in property: Name and address of fee simple titleholder: NOTICE OF COMMENCEMENT 4. Contractor's name and address: NM.. �b T (j Y L_F_ C n � c . 03 Se i-, /' E ►z_ a fi G C C .- P €. ez A kc-- FL 3 39 62( 5. Surety:(Payment bond required by owner fro contractor, if any) Name and address: Amount of bond $ �✓ 6. Lender's name and address: 7. Persons within 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: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) igna i.IOwner Prin •wners Name Sworn to and subscribed Stl a o UAd-- efore me this 3 day of . 1 u aQ, 1 g c j 1 . n f Address: 1 2,C N Q/ f.e.44/' Print Notary's Name L} k r/ t Y4- My Commission Expires: 0 3 ~ ig ' 9 t5 Notary Public 5 N OFFICIAL NOTARY S` SHIRLEY j WALKER NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC351835 MY COMMISSION EXP. MAR. 18,1998 Prepared by: 772_, ,--. N o I�; Lix„S,,Q0,4,6