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2000 DEMOLITION OF ADDITIONPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address l /) NE ?/ S Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant /r v! , Master Permit # 6 /6 4/ Owner's Address Phone 4".3 Address J d? A/6 C l S/ Xi/gm( 540,-05 Contracting Co. D W /V P r Qualifier SS# Phone State # Municipal # 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 ,)\ D e, 0/1110A/ S ' l`l�^� /e7 /fit Cf zild/G✓1, o) (X"1`F1''r`Qr" e.c.%4t as) Square Ft. Estimated Cost (value) i 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, ROOFING and MECHANICAL WORK. OWNERS 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 the above -named contractor to do the work stated. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date Notary as to Corfu for or My Commission Expires: My C • . i jes: OFFICIAL NOTARY SEAL. S MARGARITA MONTIEL � COMMISSION NUMBER } jp ;` ¢ CC79727 cO P.9Y CO.WASSION EXPIRES `�OF FA !Y. C. 17,1002 • B OND J� Q APPROVED: TOTAL DUE - ; da FEES: PERMIT 6 - RADON Zoning Building Mechanical C.C.F. CO NOTARY Electrical ‘4 Plumbing Structural Engineer Memo 9wn2 Frank J. LuBien JULY 1, 1997 OWNER STIPULATED THAT SHE WILL REMOVE THE WALLS THAT HAVE BEEN ERECTED, AND WILL SUBMIT ALTERNATE PLANS AT A LATER DATE. NOTE! CONSTRUCTION WAS BEGUN ON THIS ADDITION WITHOUT PLANS OR PERMIT MIAMI SHORES VILLAGE 10050 N. E. 2nd Ave. MIAMI SHORES, FL 33138 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE D a t e , 4 "/ 6 1 7 Job Address /102 / STe E E Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant • Owner's Address Contracting Co. 0 W Qualifier SS# Phone State # Municipal # 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 ROOD ,A b L (T 1 O ( -- Sgyare Ft. 1 Signature of owner and/or Condo President Date FEES: PERMIT Address Master Permit # Phone — 7S 7 -Oa '19 Estimated Cost (value) 3,00 . -- 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, 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 leis regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. gnOlure of Contractor or Owner - Builder 6 - - /e -* Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date My Commission Expires: My Commission Expires: RADON C.C.F. NOTARY BOND TOTAL DUE 1 1/ Date APPROVED: Zoning Biding Electrical Mechanical Plumbing Engineering 5