1092 NE 94 St (11).0
•
;. ' PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address /0 1 i l i <= . S 4 S / Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant 0.15 CON Spo(c7 cc N Master Permit # 1 17 1/3q) (./7/3 )
Owner's Address
Contracting Co. -T` P C_ N im pru SJ S t - NC_ Address /(?3 / S J 5 q u4
Qualifier c! M CQo c.Qv S - ( Phone a 33- (Po 0 8 j
State # Municipal # Competency # / 7d- 7 Ins. Co.
Architect/Engineer 4 06 k N S - '01,.00 Address •1 / 7 5 S L(, (p 3;
Bonding Company Address
Mortgagor ,> Address
•
N PCt q
BUILDIN
Permit Type (circle on
WORK DESCRIPTION
Phone
PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Square Ft. Estimated Cost (value) Z g.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.
OWNERS AltIDAVIT: 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 contractor to do the wj stat
Notary as to Owner and/or Condo President Date
My Commission Expires:
Si ature o owner and/or Condo President
APPROVED:
Date Si
ature'of Contractor or Owner- Builder
/A1. h CI! it
Notary Is to Con. ctor or Owner- Builder
Conunission Expires:
OFFICIAL NOTARY SEAL
AftIGEIA M BECKER
lG mum
�`v� c� qr .` Q
CC786697
ya 04 4. MY COMMISSION FIRMS
Of FA NOV. 15,2002
YP
BOND
Date
Date
PERMIT A FOR MIAMI SHORES VILLAGE
Date /0 _a r 71b Address / Q ! - N E ? T s Tax Folio
Legal Description j )1 9 ..- 4 3 D `�- -- G 6 6 - Pl Histoncally Designated: Yes
( 1..essee /Tenant S / Z. COLS / (rUd(0W
3
Owners Address P one o ) 6 -02
Contracting Co. ' "/ F �-r r tv C '
9.5"x- 43 ( 0 6 7 1
State # 0 b 1¥5
7.-3 5 Municipal # Competency # / 97? 3 Ins. Co. S T E [
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL P. UMBING MECHANICAL ROOFING PAVING FENCE SIGN
7 - e Po (� �o r Cori( v C� c,7` (0/v
WORK DESCRIP'T'ION / �JJ� C�
0
Square Ft. Estimated Cost (value) 3 00 pc9 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 applicable
laws regulating construction and zoning. Furthermore, I authorize the above - named contractor to do the work stated.
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT - c RADON
,t4) /D ,27i7
Sitture • Contractor or 0
/Q' ?4 9
No as to Contractor or Owner - Builder Date
Commission Expires:
PG/6, Jay D. Marron
° 4p Commission # CC 747389
Expires July 14 2002 BONDED T,HRU
,dp 4'0 r' ATLANTIC BONDING CO.. INC.
C.C.F. ✓ NOTARY
No v
Master Permit # C `7` 5 � 1 10 3
- Builder Date
BOND
TOTAL DUES -6) —
APPROVED:
Zoning Building Electric
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date // /7- Fpob Address / 0 ?2 4/E 9 9's2 Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant
Owner's Address
Contracting Co. (,� �+
9 JT' S P�<i.y�lilj c
Qualifier ....,27-5/9 e'
Notary as to Owner and/or Condo President
My Commission Expires:
itL.1 , f 1 .'A A.A.&
APPROVED:
Zoning
Mechanical Plumbing
Date
FEES: PERMT Cps. 161 ' 'ck ' RADON C.C.F.
�Q s<p.-
Building Electrical
Master Permit #
Phone
Address a 4 1f-ZSy? y /�ZZ/ 7'
3 p-2-2,13 2 7
• State # --' (Ica 637 a /3 Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
3 2:9715' 7i > &r / JA. Y , 0 tit? k/ eri ■-
�
Square Ft. Estimated Cost (valu D i' D )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 OF 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 contractor to do the work stated.
,zvD
Signature of Contractor or Owner - Builder
My Commi
No atry as to Contractor or Owner-
ion NOTARY SEAL
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MYCOi4MISSION EXP. MAR. 12002
a%e'�1J NOTARY ,
Date
Date
BOND
Structural Engineer
uilder
TOTAL DUE
ITEM
BATH TIE
UNIT
O
FE,,
' A
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
•/
ti
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
/
11,
RECEPTACLES
A/C (WIND)
DISPOSAL
/
6 /
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/1E7ER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNOERGROUHO TANKS
LAVATORY
.
bey"
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
/
4--
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
/
!,--'
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
.
171-
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP i
MOTORS OVER 8- 10 If
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTCRS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
II
3k
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR COPOITIONERS
'
A/C UNIT 1
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
/
(, /
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRI1QER -WELL
SPECIAL PURPOSE
SWIMMING P00L'
OUTLETS COMMERCIAL
WATER SERVICE
P
'f,$
SIGN TUBES
SEWER CONNECTIONS
/
(y
S GN TRANSFORMERS
-
UTILITY -SEWER
SIGN TIME CLOCC
__
UTILITY -WATER
/Q
FIXTURES
SEPTIC TANK
ANTENNA
'
RELAY
TELEVISION OUTLETS
GRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
'
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
-
AREA DRAIN
ROOF INLET
SOLAR WATER 'EATER
FIRE STANDPIPE
.
'
POOL PIPING
LAWN SPRINKLES SYSTEM
'
GAS RANGE
METER SET (GAS)
-
'
GAS PIPING
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
Date / / / ' / / ob Address /Or 2 NE- / ? Tax Folio
Legal Description Historically Designated: Yes 1'0 No
/ Tenant C C 3 9 L//S�1
� ! S 7C /Q 6 M as t er Permit #
/072 C sr s Phone CP 90 5--
Contracting Co. — l 1- 7 E I (,
qS 34/—/067
State # ele o l 5 3SMunicipal # 3 0 a . Sg /1143 Competency # 0 0 0 0 /0 ? Co. g T fl 7E P/
Owner's Address
WORK DESCRIPTION
My Commission Expires:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDIN ELECTRICAL ' LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Square Ft. Estimated Cost (value) 0 000
1
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
i^ 0 -e I.tl 0 U -e_ 7
FEES: PERMT /RADON C.C.F. 7 X"'4/ NOTARY
1`U L
d
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IIVIPROVEMENTS 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 contractor to do ork s : ted.
//—* 97
r - e 4'�- (± ate o ff z ov v
11-4)_2
No : as to Contractor o Owner `:.3J ' NOTARY SEA[,
My Commission Expires: NCTtARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR 1
BOND
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Structural Engineer
TOTAL DUE
ITEM
BATH TL8
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
/
FEE
fr d
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
L l GHT OUTLETS
A
f':
CENTRAL HEATING
DISHWASHER
RECEPTACLES
1
y 7, '
A/C (WIND)
DISPOSAL
SERVICE TEW1 ARY
A/C (CENTRAL)
D R I N K I N G FOUNTAIN
SERVICE SIZE IN AM'S 2C)0/4'
/
- 4 10.
•` DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/I€TER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
/
6.
v PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
/
3.a.5-
UNDERGROUND TANKS
LAVATORY
OVEN
1 ,.
J5
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
/
_rAf'"
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
T
"STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 if
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK. RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSE1€LIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
_
lOTCRS OVER 10- 25 HP
`
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
000LING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS 37
2.
»'
A/C UNIT
STRIP HEATER 7. Sk i
2.
46'
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -HELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
•
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
•
SEPTIC TANK
ANNA
RELAY
TELEVISION OUTLETS
IO `Y'
ORAINFIELD, 4' TILE/RES.
•
VIOLATION
PUMP & ABANDON SEPTIC TANK
_
REI ECTION
SOAKAGE PIT CU. FT.
, q
Q0 L PO I r 4'V1
I qS
CATCH BASIN
I1
f D h O 14-7
' /z-
DISCHARGE WELL
DOMESTIC WELL
..
AREA DRAIN
ROOF INLET
,3 #` --
'
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
ELECTRICAL
MECHANICAL
PERMIT APPLICAT FOR MIAMI SHORES VILLAGE
Date A' .-14 a0 Job Address /199? /l/C ( S Tax Folio it " 32-05 - 007 o f ?o
Legal Description Historically Designated: Yes No , /
Owner/Lessee / Tenant S/ 7_ COYI /2urtl t� 1:/r. (1tz,v f il G MG-46/11e //Ile { Master Permit # s ` C gj 5 7' 7 41 3
J
0 Phone 305— (5 2 — 89 0
Owner's Address / 9'0� / 9V � • 5
� AA ,, /ylr c.�u •
Contracting Co. Pxotgcti 07A hie'
/�5 So �;c�u Address ifgeo /V& -7 5f . S'& So, 3/1z-
Qualifier >� j �hv b /t/ Phone S95 590 --3005 L/
State # t C Q 2, Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDIN ELECTRIC PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION P /./F(vzlii 7 Cr$ /�Pirt4 •
Square Ft. Estimated Cost (value) --P()
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 contractor to do the work . ted.
Signature of owner and/or Condo President
FEES: P E R M I T ' - ® " ' ' RADON
APPROVED:
Zoning
Mechanical
Plumbing
Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
Building Electrical
Signature of Contractor or a er- colder Date
�'Y SEAL
SERGIO I AGUILERA
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC945225
MY COMMISSION EXP. JUNE 14,2004
ctor or Owner - Builder Date
NOTARY BOND
TOTAL DUE 5i f
Structural Engineer
PERMIT APPLICATION FOR , MIAMI SHORES VILLAGE
Date / d / Job Address I 0 / °� N1 E 9 1
T C( Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant S/ 1 C D n S-1 r C' di o k) Master Permit # ( 5 7 / 00 4 ' ` g2 / /
Owner's Address Phone o S `' E
Contracting Co. HL ' / E e 6371 r ( C - y'/V C • Address 5 � / d g4 0 E � / - lea°
� 46 r0 se � ��S 9s ` 3Y- /0 6 7
Qualifier D (/�� l Phone
State # T' 0 0 / vs-3 Municipal # 3 0 - 02S 9116 Co mpetency # / a '7 9` Ins. Co. - Filet(
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one):
WORK DESCRIPTION
Square Ft. Estimated Cost (value) 42—S0 e
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.
OWNERS 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. Furth rize the above -named contractor to do work ted.
Notary a Owl and/or Condo President
My Commission Expires:
FEES: PERMIT 4 RADON
BUILDING ELECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
T-e orilr 4
de 95 790
OFFICIAL NOTARY SEAL
GLADYS J PILLAR
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR 12002
Date No
C.C.F.
c or n (;)� G ,i AR
fires: PUBLIC STATE FLORIDA
NOTARY MISS CC714103
COMMISSION NOp MAR 120
COMMISSION
EX P.
Alr
as t. Con
(infractor or
I%
•-
er- Builder
Signature of
Commission E
APPROVED:
Zoning Building
a270
0 Y
Date
Mechanical Plumbing Structural Engineer
i
Sworn and subscribed before me this
Page 1 of 2
BUILDING AND ZONING DEPARTMENT
10050 N.E. SECOND AVENUE
MIAMI SHORES, FLORIDA 33138.2382
TELEPHONE (305) 795-2204
FAX (305) 756-8972
AFFIDAVIT FOR 30 DAY TEMPORARY- ELECTRIC SERVICE
(To be executed by Owner and/or Tenant, Budding & Electrical Contractor)
NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE"
UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED
It is understood that the temporary- electrical approval by the Miami Shores Village, Building & Zoning Department
given in connection with the building being constructed under.
Building Permit No. 9 fr , r Electrical Permit No.
at address: /o9
for owners: S/Z (-ot..S-T/IC
is being given only for construction purposes or for testing the following installations being made in said structure:
Sub - paragraph 4501.3 (d) (3) of the South Florida Building Code provides for a 30 day maximum approval only in an
URGENT NECESSITY for electric current exists. Necessity shall include the use of current for irrigation, security,
humidity control, emergency power and lighting, such as for testing or construction purposes, provided the Electrical
Contractor and owner do hereby agree to assume the responsibility of maintaining the installation in such a manner that
there is no hazard to life and property.
Such approval is in no event to be considered a release of said structure for purposes of use and occupancy, and no
occupancy shall be granted or permitted until final inspections have been called for and approved by the inspection
divisions concerned, and an occupancy permit obtained.
The undersigned also understand that the temporary- electric approval is subject to rescission and cancellation, and
electric power can be cut off at the discretion of the Building and Zoning Department and will be disconnected if the
building concerned is occupied before final inspections are approved and occupancy permit obtained
i� ✓��- , being first duly sworn,
depose and say that I am the owner of the above described property, and that I agree that the structure covered in this
agreement shall not be occupied until the building contractor has obtained approval of
/9 'A.)
day of /q
Notary lie, State of orida at Large
My Commission Expires:
1' 1 1
RE O�e �w 47'v1/451
SIGNATURE OF a TAR ' S *1, • J valAR
NOTARY PUBUCSTATE OF FIDRTDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR 1 002-
30 DAY TEMPORARY-ELECTRIC SERVICE (continue)
► r6 r0 ? 1 D refrS A/6 /-/ _c !fie C- r /bein first dut sworn,
depose and say that I am the Electrical Contractor for the above described property and that thelectrical installations as
now existing will not create a safety hazard if temporary- service is ccie
Sworn subscribed before me this e
•
i=!il
day of d• 00
Notary _ blic, State of Florida at Large
My commission expires:
flan �� `s' /Z GG
.71/3/7 , being first duty sworn,
depose and said that I am the Building Contractor of the above described property and that I will not permit occupancy
of this building until final division obtained and that I have the authority insofar as the owner of said property is
concerned to prohibit occupancy until such final inspections are obtained.
Sworn and subscribed before me this
day of
Notary Public, State of Florida at Large
My Commission Expires:
SIGNAI'URE OF ELECTRICAL Lei ECTOR
Date: Gde'
Page 2 of 2
SIGNAI
o VILLAR
NOTARY PUBLIC SfATN nr r[ nRm
COMMISSION NO. CC71416aGN
MY COMMISSION EXP. MAR. 1,2002
TRICAL CONTRACTOR
O FF NOTAILY PUBLIC
NOTARY PUB e7 A T� - t'"t
'COMMISSION N 14103
MY COMMISSION EXP. MAR. 1 t�2
OF BU1LDIN�r CONTRACTOR
( 7
OF NOTARY PUBLIC
Release to FLORIDA POWER & LIGHT CO.
by ( name) frit 1 G/ (/' 'te.e/&A/ >
Date: 07)
To: (name)