32 NE 92 St (6)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 4— 9S-
,- Job Address /-3,p 1/5" 9�; 57 Tax Folio
Legal Description / Historically Designated: Yes No
Owner/Lessee / Tenant X cry c/ VG . j� [ 1.z- A/ Z- Master Permit # 77
Owner's Address X , 5 9,4 cx w\ C
Phone
) — 7 I —i9
Contracting Co. V I/O h e Y J Address 2.`" 9 : `D S-7'
Qualifier SS #? ? - P h o n e ( o ) 75 I 190 a
State # Municipal # Competency #
Architect/Engineer
Bonding Company
Mortgagor
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
Address
Address
Address
Permit Type (circle on : BUILD ELECTRICAL PLUMBINNGx 1T /LS "21 p�' MECHANICAL ROOFING PAVING FENCE SIGN
' y '/ 9s-dv-e ea2 , i' / ESQ C�.
WORK DESCRIPTION�C / �X � � } 1:-D i �" /
00 r C./ 7 e2.,// j7q Cor/ e -72:- L/ "�. e-Zc / G / - r� / r - S H-, /� /� . it v! , e
Square Ft. j. / /7 G a/ded G—ye eo) Estimated Cost (value) `2z--)
O
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.
Sinn. - of Contractor or O ' - - Builtt r ,
ot: 1 i a3 C ��`l ' ;r J!!Gt' 6 ...;_ e`' r Date
MY C• pir:1!O. ua cci
i
FEES: PERMIT y.V RADON C.C.F. v V' U NOTARY J BOND
Date
.
TOTAL DUE
APPROVED:
Zoning Building 1/ ('14 Electrical
Mechanical Plumbing 11 - Engineering