425 NE 93 St (5)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date )‘ c t Job Address L 12 /v E 9 3 ST Tax Folio
Legal Description t O v. $ Historically Designated: Yes g)
Owner/Lessee / Tenant In I LL 4.4 T Tv.0)1 C \ •r �� Master Permit # V.0 0
Owner's Address 4 /). S /V F ? 3 v 7- Phone 3' ) �� l U ) &—
Contracting Co. 136, 1-‘0% Address L '- S £ ° -T
Qualifier Yr SS# Phone ? t , ) G 7 r
State # Municipal # Competency :11 Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
P V{ ss C tA
00 ±n Cull rte.
Square Ft. / c o O Estimated Cost (value) /0 0
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 pennit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be perfonned to meet the standards of all laws regulating construction in this jurisdiction. I understand tiseparate 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.
Date
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT 4 7 0 . RADON
Bu•
ignature of Contractor or Owner - Builder
tary as to Contratof or Owner - Builder Date
My Commission Expires:
oFRc u NOTARY S EL
43 a� PU gM oA�TA
O . Gn ooru.s N°`
2 � #
CC797
� p SON EXPIAFS
7,. O�� DEC. 17,2002
OI• F�
NO
Electrical
r2 - c)77
BOND
TOTAL DUE , S • D
APPROVED:
Zoning
Mechanical Plumbing Structural Engineer
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address 9), C / C' 3 si Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant -- Ts-1/4, 0):‘ S , � � t Master Permit # 377/ g
Owner's Address `( C N E [ 3 "'\ Sf - Phone
Contracting Co. ( 5a `S S o ''' -e—
Address L (2 S N t
Qualifier SS# - Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 1 S S L' — C (-e c..0 (Po•�,..,✓�
Square Ft. Estimated Cost (value) g G C)
tOi M
y�ut`rr?a1
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 1v1ECHANICAL 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.
Signature of owner and/or Condo 'resident Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
RADON C.C.F.
Signature of Contractor or Owner- Builder Date
of as to Contractor or Owner - Builder Date
My 70 NOTARY SEAL
0 e, SANDRA M MONTIEL
2 * COMMISSION NUMBER
Q CC401261
ct� MY COMMISSION .EXP.
OF F1. AUG. 17.1998
NOTARY 1 5
TOTAL DUE 9
APPROVED:
Zoning Building
Mechanical Plumbing Engineering