716 NE 92 St (3)Date 12/12/96 Job Address 716 NE 92 St. #4M
Legal Description ,
Owner / Lessee / Tenant Janet Marchetti Master Permit # '1 l '2
Owner's Address 716 NE 92 St. #4M
Contracting Co. Douglas Orr Plumbing
Qualifier Douglas Orr
State # 021452 Municipal # Competency #0012463 Ins.Co. 2/2/97
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Reinstall kitchen sink
Square Ft. Estimated Cost(value) $217.00
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
au_horize t'ie above -n• ed contractor tb do the work stated.
Signatu : o
Date: / ''
Notary as to Owner
My Commission Expires:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
es
f owner ' nd /or CohdouuPt sident 3
C .,
or Cbr��io.,res%de`t� .
** * * * *
FEES: PERMIT -33
APPROVED:
SS# Phone 305-887-16S7
* * * * *
RADON C.C.F.
Zoning Building p1
Mechanical Plumbing
Tax Folio 1132060440540
Phone 757 -2602
Address 301 Flagler Dr. Miami Springc
4L
Signature of off ' ontractor or. OWnerBuilder
Date: /
o , r 7
Notary as to Contrac -Owne a`Laer'
My Commission Expires:
* * * * * * **
a NOTARY TOTAL DUE 3
Fire Other
Electrical
Engineering