860 NE 92 St (15)l (c;14' PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 7 l � Job Address KO /Cie 2 A- Tax Folio
Legal Description /Or ac A Historically Designated: Yes le:),_,,; <No
&Lessee / Tenant !ice Y � � l 1 e- (00 e f Master Permit #
Owner's Address ��O v ' e ?2 s J /4 ( ( Pc i ne 7 7 7 Q
Contracting Co. P Jew Address /l' (0l 4) 9 / y / /-1 C'.J ` -.
Q u a l i fi e r .7e* e . J X . 67 a '-7 - ' SS# Phone (J - Ui 5 c3
State #
Municipal # Competency # / (r 637 Ins. Co.
Architect/Engineer Of /ms=s 4 s Sys i .7h c . Address ,/e,,,.-0/ "wt.; v_ iV V : .
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION G AS' 3e ' 1 c , ai,as ,�geox4✓l Me
Square Ft Estimated Cost (value) �F
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. F
d
a m - af owner `and/or Condo President
slq �►
Date
ra i,tw SEAL,
.
TE OF FLORI
422293 1t
P. NOV. 21,1998
(tlotary as to
My Commission xpire
FEES: PERMIT 0 RADON
APPROVED:
Zoning
Mechanical
ermore, I authorize the above -named contractor to do the work stated.
7
Building
Signature of Contractor or er-Builder
r otary as to Contractor. Owfier- Builder
/My Commission Exoir- y
oatRV P oe, Beverioy Darlington m
< Notary l'isb;id, State of Florida
< Comnairszrn No. CC 42777c ;
< � 4' 0F n e ° My Commission Expires 12/20/98
< 1- 800-3- NOTARY - Fla. Notary Service Et Bc td/z n Co. ,
C.C.F. ,- NOTARY F'
Electrical
TOTAL DUE
ate,
Date
Plumbing / Engineering
N R/W
S R/W
ALL SOD
20'
NI. 92nd. SlRL ET 50 .,
EXISTING 2" BSE GAS MAIN
PROP. E/M &
TRAN /FITT
(860)
LOT 3
BLK 2
PROP. 2'
PREFAB RISER
1. LOCATE ARP PROTECT ALL UnUnES IN AREA OF
CONSTRUCTOR. SUNSHINE /I- BOO -43z -4770
2. RESTORE ALL AREAS TO PRIOR cONOrnONS
S. ALL CONS TYUCTTON TO FOLLOW JURISDICTIONAL
GOVERMENT AND PCS STANDARDS.
ATLAS: M -3
SCALE:
NTS
DRAWN BY:
M. CHAMORRO
Peoples Gas
PROP. 1/2" PL SERVICE
860 N.E. 92nd STREET
MIAMI SHORES
DATE: 7 -29 -96
SHEET
1 OF 1
JO : L-86289
AFE: 010170000102
NR /W
S R/W
ALL SOD
20'
N L m 92nd. STREET 50"
EXISTING 2" BSE GAS MAIN
PROP. E/M &
TRAN /FITT
(860)
LOT 3
BLK 2
PROP. 2'
PREFAB RISER
I. Loc 1r AN7 PROTECT ALL lgarrra IN AREA OF
=NM(/ rat SUNSHINE /I- 800 -IJ2-6770
2. RESTORE ALL AREAS ro PRIOR CONDIITONS.
3. ALL CONSDRUCRON ro FOLLOW JURISDICRONAL
GOVERMENT AND PCS STANDARDS.
ATLAS: M_3
SCALE:
NTS
DRAWN BY:
M. CHAMORRO
PeoplesGas
PROP. 1/2" PL SERVICE
860 N.E. .92nd STREET
MIAMI SHORES
DATE: 7 -29 -96
SHEET
1 OF 1
JO : L-86289
AFE: 010170000102
ATLAS: M -3
SCALE:
NTS
N R/W
S R/W
N
N
n
DRAWN BY:
M. CHAMORRO
L.1
0
CC
PROP. E/M &
TRAN /FITT
ALL SOD
20'
PeoplesGas
PROP. 1/2" PL SERVICE
860 N.E. 92nd STREET
N.L. 92nd STREET 50"
V ----
EXISTING 2" BSE GAS MAIN
(860)
LOT 3
BLK 2
PROP. 2'
PREFAB RISER
MIAMI SHORES
r. LOCATE AN7 PROTECT ALL U1ILmES IN AREA OF
CoNSrRUCroN. SUNSHINE /r- 80O -4J2 -4770
2. RESTORE ALL AREAS TO PRIOR CONDINONS.
J. ALL CONSTRUCTION TV FOLLOW JURISDICTIONAL
GOVERMENT AND PCS STANDARDS.
DATE: 7 -29 -96
SHEET
1 OF 1
JO : L-86289
AFE: 010170000102