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860 NE 92 StPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ° Job Address9 7 / L / c 9 0 7 5 7 ei Tax Folio // 3 O, 6S tJ Legal Description 06 v /C.6 /7 a Lessee / Tenant Master Permit I'6 L /) 7 7(/ Phone S " Owner's' Address Contracting Co. /V A 0 (5M/2C7-e, Address /2 C akrdeX rrZL Qualifier 50_,0 ✓ 1 ss# (( hone A --`- ') 2(1 ' State I Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING / EL / E EC CTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION LOU) UD /A1 P c2 a, (5 G,( Square Ft. Estimated 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 coy dallOw Signature of owner , !f. /or ■ondo Pr 'dent Date: Notary as to 0 My Commissi ** * FEES: PERMI APPROVED: r and /or CAM et A 13FFICIM. NOTARY SEAL r!!ERRY L MACINNES f U BLIC - STATE OF FLORIDA „i3SSon Expires 6uly 28,1000 Comm. No. CC 572628 31'49 RADON ondo President Zoning Mechanical • tractor to do the work stated. Signature of Contractor or Owner- Builder Notary as to Co Qtp or OtinarrBuijder My Commie i Mt e{rj i , IOTARY SEAL ; SHERRY L IICHINES NOTARY PUBLIC - STATE OF FLORIDA * * � My Commission F#;pires J428, 2000 Comm. No. CC 572626 * C.C.F. Fire Other Building Plumbing Engineering NOTARY Electrical TOTAL DUE ,� , RI10 -022 I S C OF M I A M I F O L I O N U M B E R P R O P E R T Y A D D R E S S 11 - 3206 - 005 - 0150 860 NE 92 ST RECORDING RECORDING RECORDING MORTGAGE RATE MORTGAGE DATE BOOK PAGE TYPE TYPE DATE 012693 15791 2191 CON FIX 122492 B O R R O W E R S N A M E S WILLIE J AND CAROLYN A A COOPER BARNETT BANK L E N D E R L A W Y E R MORTGAGE AMOUNT MATURES TERM INT. RATE P -AND -I MORTGAGE LOAN NUMBER 25,000.00 010108 181 0.00000 0.00 747581 REMARKS F9 = RETURN TO SUBJECT ENTER TO CONTINUE F12(QUIT) TO EXIT SYSTEM IR10 <ENTER> TO CONTINUE OR <F9> TO RETURN IS