AlarmPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Y/, 47 Job Address 3& /1U93 37 Tax Folio /1 S cP o ° 6
Legal Description L' 9 1364' g7 PciT /d His' :orically Designated: Yes No
Owner/Lessee / Tenant 4 L (= SG'4 L.'OL C al)/ J 271-4/4 Master Permit # 41 € G 1
Owners Address 366 /t/r 9' 'a 7 Phone (3 7 e - 2:5
Contracting Co. 4 I7 7 see 0 ,c/7 y Address / a2 •� j%' /-e/6 .f
Qualifier 7/(/'/ c /A / SS# a2 9% . 7 770
State # kfiveoa 9 Municipal # Competency # Ins. Co.
Architect/Engineer Address
B Company Address
Mortgagor Address
Permit Type (circle one): BUILDINGCtiECTR L UMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 5 0,c77- 5) S / �/ �� l / 4 7270
C
Square Ft Estir. fated Cost (value)
l 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 YO UR 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 - ::lamed contractor to do the work stated.
5 /` fii ¢6/770
Signature of owner and/or Condo President Date Sig iature of Contractor or Owner- Builder Date
Notary as to Owner and/or Condo President Date Notuy as to Contractor or Owner - Builder Date
My Commission Expires: My Commission Expires:
FEES: PERMIT . ''' RADON C.C.F. NOTARY BOND
TOTAL DUE
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE,
Late Job Address 76060 OE cr i Tax Folio /1 - 32463 0/15 lv32.d
.egal Description Le 02,3-V 4. 84-K ef? 7()
, 76, 00/437-A-g)4 /0 E 9 3 S / Master Permit # ss \L& b� Phone 30 5 7 S ( 4 17 <9'
ontracting Co. iL77 3C!C /T`/ Address PeCt /cL //
?ualifier 7A//Y C,///A/
gna ure
te.
iA60
, /�_ _ •0
ary to Owner and /or Condo President
:* * * * * * * *
ss ��� Phone
6‘72‘f-797
state ! Municipal Ii Competency Ii Ins.Co.
architect /Engineer Address
londing Company Address
Iortgagor Address
'ermit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
!ORK DESCRIPTION Look V 1 6 -2'.x"1, ' /TY 5Y$7f»7 AfrieD a /)C625
square Ft. EstimEted _ Cost(value) `1g ® ij
TARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
O NAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
'0 OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
IOTICE OF COMMENCEMENT).
.pplication is hereby made to obtain a permit to do work and installation as indicated above, and
)n 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
'emits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
WNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
'e done in compliance with all applicable laws regulating construction and zoning. Furthermore, I
= uthorize the above-named contractor to do the work stFted.
A t_ tor J /
of owner and /o ondo crfsid t
JANET M. GRAHAM
• COMMISSION # CC60499)
%o EXPIRES DEC. 3, 2000
,y Commission Expires:
My Commission Expires:
Signature of Contr #edror
Oat f 1 .. J
, a
0.
L
T M. G RAHAM r-Builder
SSION # CC60499)
PIRES DEC. 3, 2000
Otary as to Contractor or Owner- Builder
'EES: PERMIT; RADON C.C.F. NOTARY TOTAL DUE
.PPROVED: Fire Other
Zoning Building Electrical
Mechanical Plumbing Engineering