825 NE 92 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date A03/15 Job Address £25 4-te `? /177 Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant 6 /220,71.9.1 C`ra. c4 Master Permit #
Owner's A d d r e s s t J - ' J , t ' E x / 2 - 6 , - ( . 2 /J7. �,: cT'+�u,- f J"c Phone (log 737 - oc.)oS
Contracting Co. /J /vr2) jj4/, /� J � / 9c�o.! .Z- -c . Address 2 25- ./y4 7 / Z 'r /7), ,' ��o.� / Qualifier // o o rte C- ff /�.�, SS# '( Phone IJc) 7J3' —
State # CQC (JS 7 y-? Municipal #
Architect/Engineer
Bonding Company
Mortgagor
Notary as to Owner and/or Condo President
My Commission Expires:
FEES: PERMIT
7
4)
RADON
Si a of o r er and/or
/.�
APPROVED:
Zoning Buil
Mechanical Plumbing
at
/
ate
C.C.F.
Competency #
Address
Address
Address
Permit Type (circle one)41 ILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION //f��,� / "r,.o%xt �.�., F� .J4 �. rvg i" ✓l'7 / ',- � red -7,//
,� 06
Square Ft. Estimated Cost (value) ,3? 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 authorize the above -named contractor to do the work stated.
�• ! 9� /
Condo President
ignature of Contractor or Owner- Builder Date
I otary as to eontr ctor or Owner- Builder Date
My Commission Expires:
Ins. Co.
NOTARY TOTAL DUE
Electrical
Engineering
STATE OF FLORIDA, COUNTY 0= aADE
0 NE:?9V Vii.
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VJ
PERMIT NO.
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C
STATE OF FLORIDA:
COUNTY OF OAOE:
` 2 .
2. Oescription of improvement:
4. Contractor's name and address:
6. Lander's name and address:
Section 713.13(1)(b), Florida Statutes.
Name and address:
cnd: oWnfVCo rC3
h✓�
NOTICE OF COMMENCEMENT
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property. and in accordance with
Chapter 713, Florida Statutes. the following information is provided in this Notice of Commencement.
TAX *OLIO NO.
1. Legal description of property and street address: •
3. Owner(s) name and address: S? / ' /4,9 ✓ ('!
8�� tit f ,. %
Interest in property:
Name and address of tee simple titleholder:
7
.2 25 C' S' /L - /27, S , f x 7
5. Surety:(Payment bond required by owner tram contractor, if any)
Name and address:
r
Amount of bond S
7. Persons within the State of Florida designated by Owner upon whom notices cr other documents may be served as provided
by Section 713.13(1)(a)7.. Florida Statutes.
Name,and address:
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Uenor's Notice as provided in
ill
/c/
6
Sinaat • or .41 let
Print fen Name r . J ai geki t' �� U R1'
Sworn to and subscribed before me this Z6 day of / C • , 19
Notary Public �1
Print Notary's Name 0 4 I di__ 4. A u v TI9
My Commission Expires: 0 et 3/,/ :' q 7
9. Expiration date of 'is Notice at Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
958527903 1995 DEC "26 10:37
:TaY ,e III ,/
CAROLE ANN SMITH
MY COMMISSION # CC 927051
EXPIRES: October 91,1997
Bonded Thru Notary Public Underwriters
Prepared by:
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'0 %S 'a' ��,iii!:r,T•�:
Address:
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