MECHANICALDate
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
l i Job Address /t9cR / & 9 / Tax Folio
1 Description
Lessee / Tenant Master Permit #t 3
Owner's Address _ � i%‘. 'f(144( Phone °
Contracting Co. 4 C,(J d (t4 hie_ 6 Address &� 7) � g /�v/
Phone �5 Zr' a
//rrte � - AO
' Stat � icipal #t Competency
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type circle one): BUILDING ELECTRIC PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
` o PLJ - .pie- cik0
Square Ft. Estimated Cost(value)c? 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 =•'ve -named c ractqr to do the work stated.
o c
Signature of oj-r 900144140RO° .e> dent
Date:
0 ,4 Ss1oNE °•
•
Notary as to bwne� a /d1.°Con
y ' 9CC 384336
My Commission Ex s:
silk
** * • * *
FEES: PERMIT (1 +0 RADON
APPROVED:
*
Zoning
Mechanical
Signature of \ a '
Date: �, PJ` 1 ..:.a : .
N ' °��!�y,�gB10NF
Notary asCWro
My Con mi s s r.,
d "/,81 11111111 1 \ \
* * * * * *
C.C.F.
Fire Other
Building Electrical
Plumbing Engineering
NOTARY
*
der
er- Builder
TOTAL DUE e0 %
**
Carrier
Air Conditioning
02 .'":rsiet°,"8)::rporation
- .
Carrier
Carrier Parkway
Syracuse, New York 13221
Commercial Air Conditioning
--•
1 I .
20250 N.E. 15 COURT
NORTH MIAMI BEACH, FLA. 33179
c5a- GO 1 -10 - 70-1
o nrryr Corporation - 1961
A ri ,
; r
Prepared for
AddressI 0_2
• E-53 (7-77)
,
Estimator
Salesman Isq_
Job No q
SPors_55t3g
Date_
I
(905-041)
•
Carrier
AirCondilioning
owis,,,r,
NAP Came cer
Carrier Parkway
Syracuse, New York 13221
Commercial Air Conditioning
RESIDENTIAL
20250 N.E. 15 COURT
NORTH MIAMI BEACH, FLA. 33179
c5a- 60 - 70-1-0 Li 89
0 C rr r Corporation — 1961
_.411111MIL.
r ; Prepared for4
Address 1002 hie cm sorb
MU:a SAW S _5_5138
Estimator_ ___
Salesinan_q5 dI
ig
Job Nli ricm, 5Q 0
Date_
• E-53 (7-77)
(905-041)
•ii