MECHANICALQualifier
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FEES: PERMIT
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address /a 6 ,E 9 vs/ Tax Folio
Date
Legal Description
Owner/Lessee / Tenant
Owner's Address
/`fie/ //45
/6 / ° VS/
° D
Contracting Co. S < svo _ /9A
/ /82 a-
State # F/6 Municipal # A1 -st./ /
ission Expiry6sE M. Cusco
Notary Public - State of Florida
My Commission Expires Mar 7,2000
Commission # CC 538054
AIMIN%i
a ature of owner Condo President Date
Date
9C
Historically Designated: Yes No
USN Address
ss# phone j(4 —
Competency #
Address
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN
WORK DESCRIPTION 4,019-;72_ C�' V W dZ�i /94
Address
Address
oSO 0 7 1 5 1 / 0
G yS Thyt Gt e. s f- s1 c1.e.. 4 Ten €'ii-s /de
Square Ft. Estimated Cost (value) "7 fs-47 o
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 appli :able
laws regulating con truction and zoning. Furthermore, I authorize the above -named co tractor to do the w• k stated.
Signa
of Contractor o Owner - Builder
Notary • C c
aTY � .
My C • . ssion E
00
C.C.F. •.3 • NOTARY
APPROVED:
Zoning n Building
Mechanical
Master Permit # T D67 C/
Phone c 'S ) zs " v
'fS Iry / 3, 4 -
/6,5 3 Ins. Co.
OOFING PAVING FENCE SIGN
/2
JOSE M. CUSCO
Notary Public - State of Ronda
MyCamnoslon Expires Mar 7,2000
Commission # CC 538054
Electrical
BOND
Date
% _L�s
ate
TOTAL DUE /, 3 2 _
Plumbing Engineering
1. Legal description of property and street address:
/ - P4ci
NOTICE OF COMMENCEMENT
+ s
PERMIT NO. TAX FOLIO NO. (I 3 o) 2 C"O %,
STATE OF FLORIDA:
COUNTY OF DADE:
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
7L T&0 # i /
2. Description of improvement: 2-LA.. aP lfk-t:“ 6e
3.Owner(s) name and address: 1/.//X ; 61,f,7 S (� —�,�� D /(7) C/ ( ,(JG 5y S r
/O (// // 9C-1Cf /L //t 7 r 1 ;mc.-)
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: )4 /tjx V - /t? / tom) y)
6. Lender's name and address:
Signature of Owner
Print Owners Name ,Mid .;
Sworn to and sub - - - fore me thi _ day of 1.
Notary Publi
Print Notary's Name L �; ' U �
u . DURAN
• Y N /CC775or�
MIFFS: 1
My Commission Expires: r `*' , inn,w u s,
or n,.
19 9'/m
96R547292 1996 DEC 03 12:00
5So✓vw /i .
E$ 'i " r L•R .;;• CC± �N iY OF P) c
S. Surety:(Payment bond required by owner from contractor, if ailty) snrtyr the fife + --e hue Gopy at M.
Name and address: 0.+ - ^ t`' ;^ ' •' '`' • .. " --) Z day.
Amount of bond $
c \ � - L . G C.
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Prepared by:
7. Persons within the State of Florida designated by Owner upon whom notices or 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 Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
M�
fcjo J )0)2 N mi
Address: /1JGc% H
c •