38655PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date j 1 --1-q5 Job Address 115 N • E s Tax Folio
Legal Description l Z7— Loc.-
Historically Designated: Yes No
Owner/Lessee / Tenant Ab) Th 1-ypn
Owner's Address 7 i t' . q -
Contracting Co.ji
Qualifier )3i1) Hm
State # q Sc
Architect/Engineer
Master Permit #
Phone 7 c-Ct - 7 7
Address Q t■ LO. 3( 0 AV C.-
SS# Phone ict 1
Municipal # Competency #
Address
Address
Bonding Company
Ins. Co.
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN
WORK DESCRIPTION
Square Ft. H
5
.5 T /t /l
IGN
Estimated Cost (value) gCy) UU
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.
Signature of owner and/or Condo President Date
LIY,&-ee"
Signature of Contractor or Owner-
Date
et'
Notary as to Owner and/or Condo President Date Notary as to C ,-* ^* ^r rIwner Buildor
My Commission Expires: My Commissidn BstillegP,9 OFFICIAL NOTARY SEAL
ei SANDRA M MONTIEL
44. i. COMMISSION NUMBER
Q CC401261
�f` �� MY COMMISSION .EXP.
F0F F\P AUG. 17 1998
FEES: PERMIT
RADON C.C.F.
APPROVED:
Zoning Building ACY:14
Date
NOTARY , TOTAL DUE •40
Electrical
Mechanical Plumbing Engineering
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305 - 795 -2204
Building Inspection Request
Date Time
Type Ins
Permit No.
Name -'
Address
Company
Phone #
For Inspector:
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Permit No.." I ° �� �� i• `...Q
Name
Address
.r-
Company t�7
Phone # (305
For Inspector: 1 „ Name & Djtte
Correction
Re- Insp'n Fee
ok --re)
rJ LA
SKETCH OF SURVEY is
SCHWEBKE & ASSOCIATES INC.
Vi rp Presa
11=11=.Y Lthl.LFb : That the attached
revised this 2fth day of March, 19t
Registered Land Surveyor #1067
State of Florida
FOle
44 23.70
0
N N
'340 e'
10.75
1- STY C.Q.S.
N2 715
Z3.03
v
-1 .2S
3.8
/00
H.to
13.7
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ts4 0.1
1K.c.
18 .c.4
. StA6 E / s ,3o
SKETCH CF SURVEY
Lots 27 and 28, Block 65 MIAMI . -..
SHORES SECTION 3, according to the
Plat thereof recorded in Plat Book
10, at Page 37, of the Public. Records
of Dade County, Florida.
Order No. 15235 January 19,.1955-
F.B. #324 -12 Scales shown
I. I HEREBY CERTIFY: That the attached
"SKETCH OF SURVEY" of the above des -
cribed property is true and correct
qj to the best of my knowledge and
NI belief as recently surveyed and
\ platted under my dire y .
HARRY C. SCHWEBKE� IATES_INC.
Warr./7-4. joH
Harry Schweb
Registered Land
State of Florida