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1245 NE 92 St (8)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date / 7/ Job Address O Ll S/Ut G sr: : Tax Folio Legal Description ' I Historically Designated: Yes No X II Owner/Lessee / Tenant �V O ! I Q.r avid (vn I I I L (+ I Vu Master Permit # Owner's Address 1; 46 R Z n a Phone /- 5 `l — L 9'0 Contracting Co. I v I C h c) )r (-:- G' S Address Qualifier SS# State # � Municipal # Architect/Engineer Bonding Company )[ Mortgagor f ` 066 Phone Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION A- Flu t IL) 14 v ? 0 Le ,,, Square Ft Estimated Cost (value) "'1 I O Ci 6 Ins. Co. / - A' fl 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 authorize the above -named contractor to do the work stated. Not My Signature of owne and/or Condo President Date as to Owner and/or Condo President oBts5lgg 12w t=L NOTARY ark O. /' SANDRA M MONTIEL . C . :; 1 ., + ii * COMMISSION ?DUMBER ' • 4111 c CC401261 1j• " ' (z, • MY COMMISSION •EXP. OF FV AUG. 171998 FEES: PERMIT ,1 t RADON Date C.C.F. Signatjreof Contractor or Owne ! der t Date 7-, Not My C • .�� -: ilder Date difigxpfElp IAL NOTARY SEAL e. SANDRA M MONTIEL * * COMMISSION NUMBER . II, Q CC401261 7? pz MY COMMISSION •EXP. I OF F\O AUG. 171998 NOTARY ,2 TOTAL DUE Electrical APPROVED: Zoning Building Mechanical Plumbing Engineering