815 NE 92 St (3)Architect /Engineer
Bonding Company
Mortgagor
WORK DESCRIPTION
Square Ft.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ( Address g« I . 01.4Am t 4 x Folio J) , � �14 Q3 e9//F 6
Legal Description J, 7 4'/Di tb#b / '' / 11G ;1 >r '>
Owner Lessee / Tenant ft1� L) ( Ki Master Permit #J,30
Owner's Address g Ne- 1d-S4( • ( NAM P one )-6
4m
Contracting Co. 0 C N Address
Qualifier 4 /V SS# - 4 - Phone IVAN
State # / "V f Municipal # 0/A Competency #
` V Ins.Co. c/;6' 4, Address fQ /A
1 Address /A,
d / A,-- / / / /// Address 4Ar-
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING SIGN
ch 1r I �n K f-e ems ' c_tj I
e lL i
ero
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 •
authorize the above — named contractor to do the work stated. : 4 ° " r PHINE CHURCH
Notary Pubitc. State of Ronda
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * * * * * *
Estimated Cost(value)
Signature of Co
Date : /'Q/ 0
xp. April 30, 1911
OHM nr (.7nor — Rni 1 dor
4 111_,_-. ,, J; ,, / :.,1 -I 2 uu ry.e or scam. name of Notary Public
ot - y as to Cont `gam' •' 10 8Pw4IiildeH)n
I number of I.D. produced:
Ei um take an oath, or
FEES: PERMIT ie ` 40' RADON C.C.F. 5V NOTARY , D D TOTAL DUE ;J /g
APPROVED: Fire /
Zoning Buildin
' ' 0' Electrical
Plumbing_ Engineerin
Mechanical
Other
.SPECIFICATIONS:
4 x 4' r�:c�?p P Fr.
a S -o• AG. ..
()1 WoPp ¢.4.165
FL00 . PI TYP $
X C9 Oog E4N p/c Wear: POA2 4
•
fI
Cif:APE
+� 2
F, 1(o NA;c. U. .4 SAE $
- -Top S oT.
F r up L 4 ce714=^rE
TARED. At - 4 .. .: D 65 4 . Bar,
5E4o0 "G12
— WOOD FENCE TO BE A. -MAX. OF- . ��0' HIG ....
— ALL :MEMBERS TO "BE PT W000 - SOUTHERN
- Wow: POST TO BEAT NOT MORE THAN f _O'AP A
- THREE ROWS OF 2' X 4' RALS ::SHOULD BE PROVIDED:-.
— BOARDS TO. BE 1 X 6 X 6 DOG EAN D/C W000.
— ALL NAILS TO BE ' GALVANIZED ._ TYPE. -
— NOT INCLUDED AS A STANDARD FINISH, FENCE CAN
STA.NED AS ALTERNATE.
•
0 .
{ •
,1 .