MECHANICAL PERMITLegal Description
Job Address c2 ? HE CE 1 Sr Tax Folio // (BCD /,' 3Y5
Zo 17, f 811
Qualifier
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Owner / Lessee / Tenant Merl RY t H AA2. 4//4,7 Master Permit # c3)0/5
Owner's Address - C ? N .F 9 / ,C7 Phone
Contractin Co AP /ri2G AtIn l oAr 2i ,^! Address L� /P(A/)�4 Pj7 a�S�
SS# Phone g/ q
State #(4(D A4 72hunicipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBIN MECHANICA) ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 14ri ? LJ u't T ii i „c7STc"r/7 S k-" Ddw•/,F'- i¢/.e'S'
"t R "4 r/ e("4,;,--
Square Ft. Estimated Cost(value) L , C)D D
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 laws regulating construction and zoning. Furthermore, I
..atftho ize the above -named ontractor to do the work stated.
Signature of 'owner an' /•r Condo esident Signature of Contractor or Owner- Builder
ate: Date: °{fi
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * yam * * * *
FEES: PERMIT l!1L RADON C.C.F.
APPROVED: Fire Other
Zoning Building Electrical
Mechanica0 G Plumbing Engineering,
Notary as to C•; ct &r,�84� fitarHNr
TT W DAVIS
My Commission � } < < �� n COMMISSION NUMBER
,,,
‘L' CC255237
MY COMMISSION EXP.
* * * i "p ��� _ .15 • 28. 997
NOTARY 5c-
TOTAL DUE /' /,.I
4
?Ro'6? E s T.
3�c� aTU�I
•
PERMIT NO.
TAX FOLIO NO.
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: S 7 Alf 9/ 5 i /Y1(,47 )'l ( 3 3 / r •
2. Description of improvement: C �,,� -1r«Q &. r 3:44t4.11 t c 9
3. Owner(s) name and address: FR atn t' €g S . os n0. ct c • 30.m P
aS AJr `'l • ST /hCGL.'kc s /7` '--e% 33/3K
Interest in property: 1 CD
Name and address of fee simple titleholder:
4. Contractor's name and address:
5. Surery:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name andiaddress:
NOTICE OF COMMENCEMENT
I--� R.Ani ,P, / IN 1 f2 Cr "1 (r 4 / nr-/
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(t)(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)
Notary Public
My Commission Expires:
Sig we of Owner
tint Owners Name FrcL-nc.ee S . Prepared by:
.19/y.
Sworn to and subscribed before me this day of
Print Notary':, Name , /dal c/• ._ /7,70 it'd?
NO RY PtTBLIC J IAit Ut r•LUK1UA
MY COMMISSION EXP. MAY 27.19• e c // 30 3 7
BONDED THRU GENERAL INS. UNO,
STA I E OR FLORIDA, COUNTY 0 • DADE
E tq CER!!FY i s +his is a fruo o of the
0 i f( i; 4 o.iw on day of
,A 0 r9
W THE S ,q 'r n.' . - rl °6 al; Sc.:►.
�t �rtdt: L 7IIJ ,
lip r , 4 C' w +t and Cou:.fy Courts
E Y
C !_ o.c.
94R 177 199 1994 APR 13 11:16
Address:
( 9-S -) ,c ,E" 9 / f
/?ll. 1 GL ��