1275 NE 93 St (7)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Dateg //5/91 Job Address %o /!/ .2 Tax Folio // 3c- 70//O
Legal Description .x „L , Of /O Zoe // / 13,4' ,Loge 2t/, - »(l S#0,e& t . L'9eE
Owner / Lessee / Tenant JO//4J 1 Jl, & /41/6 4 / /9! G Master Permit # J(v�
Owner's Address ;0275 /U 6 _ y--.2 ,1,,9 r ,5r 9R6 ill /4A &E Phone 7 9765
Contracting Co. f G'�Gf6 /,t/C° Address 7? 5.3 1140 g' 33/2.6
Qualifier i9/f n1 /J6., SS# • Phone fo 1
State #CGCOIica27Municipal 11 18902b? -'7 Competency # 1'79 8
Architect /Engineer A/f" Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION 51;9-r-rp d eojcee7 X7R1i/6 /9te 0
Square Ft. / G 6 6
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 accu ate and that all work will
be done in compliance with all applicable laws regulating c• str ction zoning. Furthermore, I
au o rize the above -named contractor to do the work stated.
� I
c- 1.
Sian ture of owner and
Date
Notary as to Owner and/
My Commission Expires`
** *
FEES:
APPROVED:
or Condo President
un o Pr- =ident
LEIDA K, AiY PUBLIC STATE OF NANDF.7 .
COMMISSION NO. CC a k,
PERMIT . 3,'a RADON C.C.F.
L
Fire
Zoning Buildin
Ins.Co.
Estimated Cost(value) S 000, OD
Signature
Date:
Notary as to Contrac
My Commission Expire
Mechanical Plumbing
Contractor or Owner- Builder
er iTir n.
•
LEIDA FERNANDEZ
NOTARY PUBLIC S t ATL'• C•F FLORIDA
COM I6S!ON NO CC3rf.t64
MYCOMm • I1p;Y
* _ _ **
NOTARY TOTAL DUE 411
Other
Electrical
Engineering
PERMIT NO. TAX FOLIO NO. / 13 a t2S t 7 6/ / O
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: AO /D 0 2 1 0 UR 12 75 - 71613
/YV/ /,9 f SIlya_ E.
•v■ O M.t Vt' k•v11/11VicIV1rt1Y1t1V 1
2. Description of improvement: 57 wpe-1' CO,vC:,e /- i7/e/ (/E W A y
3. Owner(s) name and address: Jazh)N ■ h,56 ) if th E J / 4/
G
i� 73' N € F2 l/ 771/ .Shb2Es f -3 1 3$
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: SIA77T
7 3`21 al e t / A 3.3/x,6
5. Surety:(Payment bond required by owner from contractor, if any) F DADE
Amount of bond $ w,7E OF FLORIDA, CO if o h o �p.qr o f the
.I. ♦ / .__ i i Q°
t►� Cf*itrr r .y
Name and address:
I 'WWI o ffice on
o 1,001 l�l•I}n] A p 19
6. Lender's name and address:
ithaV
7. Persons within the State of Florida designated by Owner upon whortho
by Section 713.13(1)(a)7.. Florida Statutes.
Name and address:
,, , id
r
Sig ute of Owner
Print Owners Name J O EP f"/ A'E & /'4 106-
Sworn to and subscribed before the this / day of ttot, 19 v .
Notary Public
Print Notary's Name
My Commission Expires:
1
/ 4.. _A rel, -V f: zTAIIIMiiar•
Y . .Al. -
DA FERNANDE.?
Afltaav pt tulle' STATE OF mom.-
NO. CC365664
MYCOMMMON CO. IvV.Y 11244A
i ,..:d Of`i:iol' Sen . Q t:
PAM CoLERit eviSA-C■•=-14'c
agy
VITA/1_
94R394832 1994 AUG 17 10:03
'1N-t other documents may be served as provided
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)
Prepared by: T)OLOi2_6'S i9ZVEctl7`ERoS
Address: 73 5 3 7/ to 8
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DETAIL
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5KETCH OF 5URVEY
Or
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y 1/RE
IA All ? ?F5 Vii !G J. , ni_'G.= CO, , FLA
icccxrding to Plat °Tg C Oi
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t.:� Pu'.1 .. R....GrGs of Co a. c.c ,.��. �
SURv .YOR'S CER i lFiCATION: We hereby
certify that the a�.attached d "Sketch of Sur -
1 `` •' of t`i V above d`a�cribev Proper f is
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true and correct to ho 1::est v i, our kr,o..i•
edge and belief as recently s::rveyed under
our direction.
DONALD W. MCiNTOSH & A.3SOCIA i ES. INC
Reg. Surveyor 20°_:4 St to of Ficrics
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