1053 NE 94 St (8)Date tin) 0 U Job Address `OCb N t G Tax Folio
Legal Description .i ° 1Cb1�5 t\ \O 00
` 4tDfeS
Owner/Lessee / Tenant �U l� ^ -`a x % Master Perm' r' 7
�fl 6 tr) i l l e Owner's Address \OS�J - C \ a 43'�C�ik 1Z flu 51D (0 5 Phone a tAk .)5
Contracting Co. Coed <el \L,n Ay. (CM)...
(� Address�j d� K�
1 \ \ fi e; \
Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDIN a ELECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Mi) col a ko-v (occ 6( ', P6(21 i ( Dk1i\aS
FEES: PERMIT' fr(_320 RADON
APPROVED:
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Mechanical Plumbing
Historically Designated: Yes
N oi
Square Ft. Estimated Cost (value)
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 • uthorize the above -named contractor to do the work stated.
/0 -17 OG gzle
...)" A,'
Signature f o • and/or •ndo Pre dent Date
3o 12S762Go p d Signature of Contractor or Owner- Builder Date
I ' � � S
OlAt , • 7 -0 a
No as to • er an For o a `I '' 1 �'
Notary s.( I.AR Date Notary as to Contractor or Owner - Builder Date
My Commission Expir GARY P BLiC OF H Op pA My Commission Expires:
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR. VS
C.C.F. (• g V NOTARY BOND
Building Electrical
TOTAL DUE
No )S
Structural Engineer
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. 1 1 _ O�— O\ a- - Ov 1 0
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.
eat add ass: -,o tC - - �
2. Description of improvement:
•
•
1. Legal description of prope and s
t
ut
3. Owner(s) name and address: rf-‘ - '
(os3 �� �� �� M -pAAN�� -• 3313
Interest in property: *-
Name and address of fee simple titleholder:
4. Contractor's name and address: _ L % 1 -
6. Lender's name and address:
Siena • o10w
Print Owne
Sworn to and subscribe
\0S 3
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
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., Florid Statutes, •
Name and address: V42.) ak.- C ~
.1-R -1 , -� �r l`�DC - eC- 331
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:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is s
•arty
e me this /4 da of Ql1 , J
/! ,. _ i
Notary Publi i�� "7?'?�II.i3
Print Notary's Name -
Mv Commission Expires:
Bonded Thnr Notary Public Undenwrfters
1
STATE OF FLORIDA, COUNTY OF DADE
I HEREBY CERTIFY that this is a tr a opy of the
oriveal fit rd in this office on day of
f 1 g , A D 20 n 6
WITNESS my hand and Official Seal.
HARVEY UVIN, CLERK 1 Circuit and County Courts
By €o C D.C.
00R503784 2000 OCT 19 10 :12
3 3 O 2-0
Prepared by: that's Colo
Address: 3 N. 18' in,
ll,/rwevr� FG -
33dZv
123.01 -52 101913
I V Jol; Address Vi'0?)0 L ) A k t W • Tax Folio - 0 ' ()Oc\D
scription -e) C OF \AZtL S I` 0,4V et$01 Po :"y
j Lessee / Telta nt \,Qk1.1 M i
-n^
�.adr. ess U J \� 1�-N Ac Y kL�Mk'ID ) J� Ph'
go�_i t C ( i h •ti.e` SS#
Phone 9 5 - `i P. b— 11-5- n c w - J 3
Address
Address
Address
i mac/
(:).`15 U. c) d
:D YOUR FAILURE TO DO
JPERTY (IF YOU INTEND
EFORE RECORDING YOUR
as indicated above, and
e performed to meet the
understand that separate
'CBCHANICAL WORK.
.e and that all work will
zoning. Furthermore, I
PAVING PENCE SIGN
Signature of Contra tor or Owner- Builder
Notary as to Ck1 d u tor 0 010000RF6'ABiltder
My Catnmi s s i on !. e • (,COMMISSION # CC733353
III EXPIRES MAY 04, 2002
* �' 9 FI . `'' A AG NOTARY 3 F FLORID k
C.C.P. NOTARY TOTAL DUE
Fire Othex
Building
Plumbing Bngi
954 926 180:1 PAGE.01
Elect7ical
1
( (AT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
LIGHT OUTLETS
CENTRAL HEATIIG
RECEPTACLES
A/C (WIND)
SERVICE TEMPORARY
A/C (CENTRAL)
SERVICE SIZE IN AMPS
DUCT WORK
SERVICE REPAIR/METER CHANGE
REFRIGERATION
^
APPLIANCE OUTLETS
PROCESS AND PIESS PIPING
RANGE TCP
UNDERGROUND TNNKS
OVEN
ABOVE GROUND TANKS
WATER HEATER
MOTORS '
U.F. PRESSURE VESSELS
STEAM BOILERS
M3 TORS OVER
HOT WATER BOILERS
J/3 C
MOTORS OVER
MECHANICAL VEUTILATION
7,ES:CEh'Cc
MOTORS OVER
TRANSPORTING .ISSEWLIES
_
- JER
MOTORS OVER 8- 10 FP
ELEVATORS/ESCA ATORS
CLOSET
MOTCRS OVER
FIRE SPRINKLEF SYSTEMS
MOTORS OVER " FP
COOLING TOWER:
=-J`'°
MOTORS OVER " FP
VIOLATION
1:2TES
''a'"
A/C WINDOW
REINSPECTION
!C:
AIR CONDITIONERS
STRIP HEATER
GENERATORS TRANSFORMERS
.
GENERATORS TRANSFORMERS
'.
. ( _::R -FI=LL
SPECIAL PURPOSE
"-OCL
OUTLETS COMMERCIAL
___
SIGN TUBES
ti.;
SIGN TRANSFORMERS
SIGN TIME CLOCK
'-'
FIXTURES
ANTENNA
TELEVISION OUTLETS
,- T:LE/ ES.
-' •C
VIOLATION
'ANK
REINSPECTION
ALL
S" STEM
•
7 - %T7ON FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A EASTER PERMIT HAS B.
WNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSE4UENT APPLICATIONS.)
71UMBING
954 926 1809 GUARDIAN 0 003
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
17 '2:000 13:39 FAX 954 926 1809
A�D'oved
TRDIflN
-.13a111 TIONAL
g eneral Office
{; -i ( milt Fax
921 -1809
- (954) 926 -5200
(30!) 379 -3780
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GUARDIAN
To
From
Fax #
FAX COVER
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emarks
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Ejoo1
nl I0TICE
• THIS FAX TRANSIIISSION IS A
CONE IDENTIAI. DOCUMENT ANO IS
• INTENDED TO BE: READ ONLY OY THE
• RECIPIENT LISTEII . ABOVE.
•
# 01 Pages
Includ'ng Cover
CO 2L DO Guardian International, Inc.
Stole License EF0000976