335 NE 93 St (8)Date // // ��
Legal Description G-DA #� a� t as `D c� 7�P ni-)7 .eve)
Owner / Lessee / Tenant + o o r _L. lV1A S-e
Owner.' Address 235 /-J 9Es '
Contras. Co. e ea / - f�
Qualifier f-'w /O -/ i / /�pv2 ss# /
P hone
State # Municipal # //,/-71-4 S'
Architect /Engineer_ d/17v `r iie2vt)/ 1 ,5750 G• Address
Bonding Company "( L24-71./e2
:;;o; RA-1 (4 0 r{ G J Cm--
J
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING
10 5 6 ( - k-o ` T)0 �►� Is
WORK DESCRIPTION
Square Ft. 7 Do
Signature
Date:
Notary as to Owner an
My Commission Expires:
** *
FEES: PERMIT
`PPROVED:
' PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
nd s ident
Isslon : E
' ; Exp Mac 16 1997.1.„:
%, ''•.. CC 267072,W
* * * ���Rr� FLO..`*
Job Address 934-- Tax Folion � ®�~ 1211
RADON
C.C.F. 1 NOTARY
Zoning Buildin
Mechanical Plumbing
74,61
a S`/ ies gec1- -g/
Pb. /o -joy. - 7p .
Master Permit #3609
Phone
Address /-370 /U e
Competency #0000 /o�3a`1 Ins . Co .
Address
Address
Estimated Cost(value)
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 •o e-na d contractor to do the work stated.
Signatur
• Contras • r�o ' lder
_ ;o ff .•
f A , NT a N c
10
Notas to Contractoro . :4•�;, ;M,yhilae>r
�
My Commission Expires: - .Exp. Mar 6 161997;
' j�'• cc 27072. .
* * * * * * ,, ,,l,. , *� , ti **
Y TOTAL DUE 1 I (1 49
Sign
Date:
7 ( Zr .
//so.? Nom) .
MECHANICAL ROOFING PAVING FENCE SIGN
1 u.) t t:b o en �qs
Other
Electrical
Engineering_