1240 NE 91 Terr (10)icipal I
— PLICATION FOR MIAMI SHORES VILLAGE
7 6 /v e" 9/ YZ-. Tax Folio //•. ■ aJ• DD /. *
e J ,C 'k SD n Master Permit Ik V-7
NG ''! 7` 53130 Phone 756
F y SS4k 3 v 07” Phone ✓r rCpS
Address
Address
Address
one): BUILDING ECTRIC PLUMBING MECHANICAL ROOFING PAVING FENCE SI<
NER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO L
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEV
NANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU
)MMENCEMENT).
s hereby made to obtain a permit to do work and installation as indicated above, al
led addendum (if applicable). I certify that all work will be performed to meet tf
all laws regulating construction in this jurisdiction. I understand that separal
Squired for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
ATIT: I certify that all the foregoing information is accurate and that all work wi.
pliance with all applicable laws regulating construction and zoning. Furthermore,
above - named contractor to do the work stated
and)•. '
►g
fAlres dent
MM
Und vtm'Grs
Competency # Ins.Co.
Estimated Cost(value)
Si
Date:
//r
. , • Vii;
ner nd/or Condo President Notary 7 o Cod :e* r__.or_a er- Builder
xpir-s: My Commission Exp'res:
*
Other
Owner- Builder
*
RADON C.C.F. NOTARY TOTAL DUE
Fire
**
Building ElectricalG!"`�.� •'t6�'G'yfs
nical Plumbing Engineering