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ELECTRICAL PERMITAmount of Permit S STATE OF FLORIDA, COUNTY OF DADE. j ss. My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit Date f Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address _ 4'r. Le No Street Registered Architect and /or Engineer Employing Electrician's No a_ ____ _____ __ Location and Legal Description Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) New Building _ Remodeling Addition _ Repairs No. of Stories (Signed) Street i,. 4 ______„_____, _ li Overhead Conduit. ,42._ Main Sw. _i ' Service � Size Feeders �_�__ f • � � Amps. Main Fuses__LI21i _ Amps. Type of Installation— Conduit Tubing _ B.X.L. Metal Moulding __— ______ _____ ____________ Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. Notary Public. State of Florida aster Electrican. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO.LA MPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST n Ld . / f� r' / / 0/ , / / / / 2 - CHECK J ,� �` (� ! V ' /'7 r .2 • ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST - . CHECK Amount of Permit S STATE OF FLORIDA, COUNTY OF DADE. j ss. My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit Date f Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address _ 4'r. Le No Street Registered Architect and /or Engineer Employing Electrician's No a_ ____ _____ __ Location and Legal Description Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) New Building _ Remodeling Addition _ Repairs No. of Stories (Signed) Street i,. 4 ______„_____, _ li Overhead Conduit. ,42._ Main Sw. _i ' Service � Size Feeders �_�__ f • � � Amps. Main Fuses__LI21i _ Amps. Type of Installation— Conduit Tubing _ B.X.L. Metal Moulding __— ______ _____ ____________ Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. Notary Public. State of Florida aster Electrican. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building PERMIT N° 3933 0 0 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA DATF Contractor's License No Work to be performed under this Permit B1 Alf- eo 0 I t r OsPi 19 Subdi- vision Value of Amount of . "s7 Project $ +, Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawlr►gs or in the statements or spec' ations and that he assumes responsibility for work done by his agents, servants or employees. J Signed / . .:1( f BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ao• cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ ELECTRICAL [ PERMIT N° 13141 DATE PLUMBING I ROOFING ❑ Work to be performed under this Permit Owner of Building i .� . � _,,+. Architect Contractor or Builder Legal Lot II Bl. Description Address of 1 } Building T � c CONTRACTOR OR BUILDER Subdi- vision Value of Project $ Contractor's License No Amt. of Permit Signed. L � -+'- BY BY A This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device descnbed in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with an plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be at any time if the work is not done in com hence with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the res • 'bflity for a thorough knowled of the ordinances and pertaining to the work covered hereby whether shown on the plans or drawings or in the . • eats o specifications and he assumes- work done by his agents, servants or employees. In consideration of the issuance to me of this permit I agree to perfo ` work covered he ` der in compliance with all ordinances and regulsy pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores In accepting this permit I assume responsibility for all work done by either, my eef my agent, servant or employee. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building �s r, P IT? � 11313 ❑ Work to be performed under this Permit In consideration of the issuance to me of this permit I pertaining thereto and in strict conformity with the plane, dra In accepting this permit I assume responsibility for all work CONTRACTOR OBf BUILDER MIAMI SHORES VILLAGE, FLORIDA Subdi- vision Value of Project $ Sign BY DATE Contractoes License No Architect Contractor or Builder Legal Lot II B Description. Address of r�, Building %-` � This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not clone in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and s, pertaining to the work covered hereby whether shown on the plans or drawings or ' r +s e statements or cifications and that he assumes responsibility or work done by his agents, servants or employees. u Amt. of Permit $ .r! perform the work covered hereunder in compliance with all ordinances and regulations statements or specifications submitted to the proper authorities of Miami Shores Vr'Wge. by either, myself, my agent, servant or employee. BY AUTHORITY INSPECTOR Permit N Amount of Permit $ )OB ADDRESS r-7 INSPECTION TIME READY REMARKS ELECTRICAL INSPECTION DEPARTMENT PLICATION FOR ELECTRICAL PER T Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub fitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance o Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be co lied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. I ?a/77 Pr k Owner's Name and Address T ? r 11 4 Registered Architect and /or Engineer • e Employing Electrician's Name Location and Legal Description Lot Block Subdivision State work to be performed and purpose of building (By Floors)... 4°4" ') 't e, ,-- .4 , k: te t k Street and Number where work is to be performed —No Street New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P P Type 1,f In tallation— Conduit Tubing 1 B.X.L e Moul • ing -e o f Miami Shores' . fiver. MIAMI SHORES VILLAGE DATE f , . : r No Street The undersigned applicant for this building permit does hereby certify labor under the Florida Workmen's Compensation Act, being Section tO" has complied with the provisions thereof ' work to be o erfn.••• --I N° 4505 No Street t Electrical- Iiispector that he understands and accepts his obligations as an employer of " ompiled General Laws of Florida Permanent Supplement, and from all contractors or subcontractors employed by him in the r inspection on the site of the work such public notice or notices mtractors, on work to be performed under this permit, as are Pl to administer oaths and take acknowledgments, personally says that he is the ication, and that he did sign the same, and that all facts Notary Public, State of Florida made necessary by improper notice for inspection, or faulty SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACE HATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK INSPECTOR Permit N Amount of Permit $ )OB ADDRESS r-7 INSPECTION TIME READY REMARKS ELECTRICAL INSPECTION DEPARTMENT PLICATION FOR ELECTRICAL PER T Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub fitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance o Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be co lied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. I ?a/77 Pr k Owner's Name and Address T ? r 11 4 Registered Architect and /or Engineer • e Employing Electrician's Name Location and Legal Description Lot Block Subdivision State work to be performed and purpose of building (By Floors)... 4°4" ') 't e, ,-- .4 , k: te t k Street and Number where work is to be performed —No Street New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P P Type 1,f In tallation— Conduit Tubing 1 B.X.L e Moul • ing -e o f Miami Shores' . fiver. MIAMI SHORES VILLAGE DATE f , . : r No Street The undersigned applicant for this building permit does hereby certify labor under the Florida Workmen's Compensation Act, being Section tO" has complied with the provisions thereof ' work to be o erfn.••• --I N° 4505 No Street t Electrical- Iiispector that he understands and accepts his obligations as an employer of " ompiled General Laws of Florida Permanent Supplement, and from all contractors or subcontractors employed by him in the r inspection on the site of the work such public notice or notices mtractors, on work to be performed under this permit, as are Pl to administer oaths and take acknowledgments, personally says that he is the ication, and that he did sign the same, and that all facts Notary Public, State of Florida made necessary by improper notice for inspection, or faulty Permit No 3533 Street and Number where work is to be performed —No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 9 Date F� ` Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address... �c `.�' � No /, Street ....�E`' Registered Architect and /or Engineer 0 J �) ? �/ ^� l �ti�c: /- Employing Electrician's Name k a.., E ...... No ,,/ 4� Street Location and Legal Description Lot Block Subdivision ;t, Street..,.;/ t� State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ � (Signed) ' ' a ` - Vy -- Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, } COUNTY OF DADE. 85. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires (Signed).( Notary Public, State of Florida r Electrician. NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACC H r ATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1•0 HP NEON TRANS. RADIO TOTAL CONTR. LIST i . ,- r cj.,v CHECK Permit No 3533 Street and Number where work is to be performed —No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 9 Date F� ` Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address... �c `.�' � No /, Street ....�E`' Registered Architect and /or Engineer 0 J �) ? �/ ^� l �ti�c: /- Employing Electrician's Name k a.., E ...... No ,,/ 4� Street Location and Legal Description Lot Block Subdivision ;t, Street..,.;/ t� State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ � (Signed) ' ' a ` - Vy -- Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, } COUNTY OF DADE. 85. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires (Signed).( Notary Public, State of Florida r Electrician. NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I SS. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 1...." I 4 ( Date ! J.°"2 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su$mitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. (Signed) . No Street Street The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to licensed by Miami Shores Village. Owner's Name and Address Registered Architect and /or Engineer Employing Electrician's Name ' / ( 5 Location and Legal Description Lot Block Street and Number where work is to be performed —No O State work to be performed and purpose of building (By Floors) —) '77 S New Building Remodeling Addition Repairs No. of Stories ^ 6 C _. 5.!_. 14o 6 / b Street (V � .2 /7/ 0, Subdivision E 1� t__ Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding (Signed) Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and sub - contractors employed by him in the of the work such public notice or notices be performed under this permit, as are Master Elect ian Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST . CHECK ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST I CHECK Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I SS. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 1...." I 4 ( Date ! J.°"2 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su$mitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. (Signed) . No Street Street The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to licensed by Miami Shores Village. Owner's Name and Address Registered Architect and /or Engineer Employing Electrician's Name ' / ( 5 Location and Legal Description Lot Block Street and Number where work is to be performed —No O State work to be performed and purpose of building (By Floors) —) '77 S New Building Remodeling Addition Repairs No. of Stories ^ 6 C _. 5.!_. 14o 6 / b Street (V � .2 /7/ 0, Subdivision E 1� t__ Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding (Signed) Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and sub - contractors employed by him in the of the work such public notice or notices be performed under this permit, as are Master Elect ian Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 9 CX2 Job Address 4 /2 0 6 7/ .s r• Tax Folio // 3 -0/ 9 G 0 0 Legal Description Historically Designated: Yes No Owner/Lessee / Tenant WORK DESCRIPTION TA d h/ c)) 1 , is Owner's Address 4 / 1 A0 , ij wst Contracting Co. /4 ) r ,s ec r,' Qualifier Mt/r-70114l .4i7(Pr 654r)®o (C� Municipal # Master Permit # Rc! /cam? CCyry -//e._&-, e "7 1 Zug e� 33,E Er (qs' ' ) Shoo- s - 9 / 6// � �'?°S /9, Phone Address / ? d /7 ,slip L/5 # /sue ss# Phone (o) 639-306*- State # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDIN ELECTRICAL $ UMBING MECHANICAL ROOFING PAVING FENCE SIGN Square Ft. Estimated Cost (value) k N o2-9 . 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. Signature of owner and/or Condo President Notary as to Owner and/or Condo President Dat My Commission ExCIA., NOTARYSEAL ALi3A GAONA NOTARY PUNIC STATE OF FLORID e d COMMISSION NO. CC858343 3 MY COMMISSION EXP. JULY 26,20tJ FEES: PERMIT .4 - 4 T1 RADON APPROVED: Zoning Mechanical Plumbing OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work )' done in compliance with all applicable laws regulating construction and zoning. Furthermore, I aute the above -named contractor to do the work • j Date Signature of Contractor or Owner- Builder Notary as to Contractor or Owner - Builder My Commission E pj CIA.•., NOTARY SEAL ALBA GAONA !NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. � LMY COMMISSION EXP. JULY 26,2003 C.C.F. t �jU NOTARY �(, BOND Building Date ie G Z4( Da e TOTAL DUE Structural Engineer