PAINTlUILDING
:LECTRICAL
' LUMBING
100FING
)caner of
luilding
.rchitect
cntractor.
,r Builder
.egal Lot
)escription
>ddress of
iu :lding
MIAMI SHORES VILLAGE, FLORIDA
LI
PERMIT N? 4903
CI
C
Signed.
CONTRACTOR OR BUILDER BY
Work to be performed under this Permit__
Subdi-
Bl. vision
DATE—
Contractor's
License N .
Value of Amount of
- l95
Project 1 -- - _ -- __ -- Fermit M - -- ____ --
This permit is granted to the contractor or builder named above to construct the building or to i.ns.tall the equip. M3111 or device described in
,er?for in strict compliance w;tn all ordinances pertaining thereto and with the understanding that the work will be performed in comoliance
ravings, statements or speciiiccttions that may have beer. submitted to and approved by the proper municipal authorities. This Permit may he
me if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A furher consition upon whir
- ranted is the understanding that the contractor or builder named above assumes the respansibi:ity or a thorough knowledge of the ordinances
, ertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and :het he assumes reaper
on- by his agents, servants or employees.
the application
.vith any plans,
revoked at any
.h this permit is
and regulations
sibility for work
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ord:nances and regulations
,ertc_ning 'hereto and in strict ccafcrmity wile the plans, drawings, statements or specifications subm:. ted to the proper authorities of Miami Shores Village, In ac-
opting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY
U
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L
L 1
.C?
CATnrC2f.4.3
geriAdzz
I Lit.? pqnrait to G ■-eil eNQ nJorrt.er0" J:
Lorcfc." tr: VilT t if on •deciat..fry v )r °to.
Onoc. ctroaeag,) convcrmeatc Cr epee hove
Q t DO C1 tree if the rz oc, rci74-1 wat nu_
Gcntztred io the JrAavornaday_ :Lot robtroltot
reGuloeto= peplum:v:1G to the c cove7ed Levens, wbether
mbilify or e= b *.o a/ FD°D. r ervrr empkqt
COW or Deal
*J[Q:71-
QC> [100 °070 C.9.1c7 „
1. uars.a
0011i.0 the °et
13nti
ord.norXen ca 10 th.::
r bapiclot Lamed above
chawc on the tarn or
tr
VI
Value of
_) ••-• • '
- —
CCO301C.VG.;(70:..(1
L6,07356 rr
A11:• itro ° o
AUTC-COEIBTAT
qi.
c
tr.
4
F
:ic 41 alrreii rke rquapmerr or de e Ica dett ( 3
•
the 4nt:eratend.nE, PI:: be. perforrned compli.nle w-r-r nu
orr.vei rtle proper racelcipn nct<l)c.rit,e0 Tim Permat enat fto ievotv°,
pinco choced without nuthortantion. further cond,tion upon wo.tcltr
.r-aumen the reaponiiery for 3 friffr:ogi, artowiedae of the vAt.lanretr
drnwingtr or in ale canternerno or svc■ficarmao nrd that be OU901TePS venpon
•
/
_ _ _ , !INSPECTOR; DV ._ _ _ ---- -----
In cons:dern:, of r';. .socton..? Cu me et thiq pViDet. I aq•ee tc perfocc) the worm covered hereunder in icomptianre with nil orthonnces and rec,:AIntior:-
(pertrair3 atrureiv nod in certet codisornnity with the plans). drowloris Dentemente. or vecilmotiono auttraiteed en the proper authoeitiea of Miarriu Shore° Vil!nGe
la neavportg tots p--...,,ryn i (.10.1tUnq recponalbtlity for ni! wortr done b) either, myaelf. cav /acme.. oeffc•nza or employee.
Date`;
Legal Description
Owner's Address i
PERMIT AP LICATION FOE'" MIAMI SHORES VILLAGE
IP
Job Address _, „
Owner/Lessee / Tenant pia1 1� iv ^t>
L
•
pp ;
Si ature of owner and/or Condo President Date
No 'Lary as to Owner and/or Condo President Date
My Commission Expires:
,
Tax Folio
Historicaly Designated: Yes
No
•
Master Permit #
"1
Phone :
Contracting Co. __ , L�� / f`� /� �� Address
Qualifier SS# - Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle cue): B1JILDIIlG ELECTRICAL PLUM 'ENG MECHANICAL ROOFING PAVING FENCE SIGN
_
WORK DESCRIPTION �`� C�,�.� — � i�� � r W
Square Ft. Estimated Cost (value)
ARMING TO WNER: YOU MUST EC hr r & A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
?IESULT IN YOUR LAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOU " 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.
Signature of Contractor or Owner- Builder
FEES: PERMIT Gi ?. RADON C.C.F. NOTARY ; ° ?OTAL DUE
Date
/ _ .Z�:..., -,2 - z /� '�! j 60 ,e,, '2,. �' d iioe. ✓_.
IVotary as to Contractor or Owner- Builder Date
My Commission Expires:
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
I