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DRIVEWAYPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 1 1 -. 02g% Job Address /Q .0 NE. �L E..e—e Tax Folio Legal Description Historically Designated: No Owner/Lessee / Tenant � Master Permit # �� � Sf Owner's Address 1 j0 , . 5 Phone Contracting o. ' '' A. D b 3, 1 O «• I q q g V � � i• � E,3� � � � ' ( '{' • Address Qualifier A \ m s t9 State # Municipal # Architect/Engineer Bonding Company Mortgagor Address Zipc Not ar'v as to Own - • a • • My Commission t APPROVED: Zoning Mechanical Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE WORK DESCRIPTION 1 Square Ft. Estimated Cost (value) 44 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. ignature of owner and/or Co do President ate o HORTENSIA C. DE LOS SANTOS - MY COMMISSION # CC 408855 --'a= EXPIRES: September 21,1998 ,p�;100 Bonded Thm floury Public Underm tern ondo President FEES: PERMIT off'. 0 0 RADON Building ate r✓a SS# Competency # Ins. Co. Address Address •‘"A) Yes ignature of Contractor or Owner- - Phone cp_35- ?4- J J Notary as to Contractor or Owner- Builder My Commission Expires: C.C.F. . '0 NOTARY OFFICIAL NOTARY SEAL EMANUEL R. FRYAR IR. NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC204285 MY COMMISSION EXP. IUNE 27, 1996 Electrical lder Date Date TOTAL DUE 4 /0 . Plumbing Engineering 7. TH STREET, SUITE 202 ALORIOA 33126 JGHONE: (305) 2263171 .4X:(305) 554.7622 r L-07— l/ Liu. itritetjurs t LAND SURVEYORS SKETCH OF SURVEY Scale "= / Z — cor SURVEY NO. ;/lc - � • SHEET NO. - Z- 2- PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date p Job Address / ® 8 0 % 3' Tax Folio //- 3? OS - O / a - CO a 0 I{ /R 13`/ 4 7/.0 .0 7o fhi4mI J,9c4& Legal Description Historically Designated: Yes No Owner/Lessee / Tenant in4 S- T4 (/ (.. Y Master Permit # Owner's A d d r e s s /68C NE. ? $ r Contracting Co. 0Q £iQ 7 tJ. 4'5 'I , AC Address 'Jf6 jV 1J , So. ,evex ,�eQ Qualifier 0 d EQ 7 C ,`,' S' a 0 SS# - Phone n 2'.,.� state6 !e A Sc 6 t76 Municipal # Competency # Ins. Co. /140&« Architect/Engineer Bonding Company Mortgagor /dV©AI Address Address Address Phone 7Sg - c 3174 Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION lee Nov t' �'Ok$ / /, (i 1c4 t7 t /U is .4 ve ,..c t Ar /W,L M 1 Co4.x',tF7e "091.4 Square Ft. 5LI,'/ S.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. ,age.going..inftion is accurate and that and z: 1 ' a j-rmore, I Attie above -named contr MACK T. WIGGINS No ry Public, State r: ida . expires N ? 9 `omm -x Il OWNER'S AFFIDAVIT: law,sregulating constructio gnature of owner and/or Not ' as to Owner . '.' or Condo President Date My Commission Expires: t 2_g qQ o o® FEES: PERMIT Y0. < 5 RADON Signature of C.C.F. , /. ; y am ' NOTARY TOTAL DUE 3 `Y2 APPROVED: Zoning Building E% / ' 0 Electrical Mechanical Estimated Cost (value) t�l 2� 6 62 otary Pu My C ontr .ul. b' s tated. MIS /Tr c St n; es Igor 1,7 1999 or or Notary as to ContractO'or Owner - Builder My Commission Expires: ////9' Plumbing Engineering liance with all applicable CC Date gy/ Date PERMIT NO. TAX FOLIO NO. / / "' 320c— 0 (2-0c ) 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. 1. Legal description of property and street address: /0&o i) . ( lc S7Prad kamy pp/7" m 42/19/ 51-kAees P. P,i r 2 2. Description of improvement: PiZmW �x /S7iN� On.�eRu7v b2_)v.�i(>97 STQ./PS !l(��) e W2.g 9aQ/Z5 3. Owner(s) name and address: / 'ILI bra/ X k) -6• QS S77 $ /1011 S } �� Interest in properly: Name and address of fee simple titleholder: 4. Contractor's, name and address: Rte' i 4'3Sz /1>.t,U. 'c 7 k aro& Dit i/ 33r& 5.•Surey:(Payment bond required by owner from contractor, it any) Name and address: Amount of bond $ 6. Lender's name and address: 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: 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) Official au! t t 111 i e BrQct Sworn to. and subscribed. before me this a 3 ; d ay of 4ctrsr , 19 `fib . x SI,, ure oI Owner Owners NameOwners Name Notary Public �i 14 1 J r : l i/ Print Notary's Nam 244.09,c ( � - (.Jr/c) ia, s Fr My Commission Expires: /1J ?19$ I s7ATE OF FLORIDA', COUNTY OF DADE i p MEI2E ©YCEt7r1PV that this 5s a Oruo yop ? of Pho oil; II land inPhls ofilcr on daYo NOTICE OF COMMENCEMENT WIum n HPRRVEY e MACK T. WIGGIN3 III Notary Public, State of Floride My Comm. expires Nov 17 1998 f cInl Sonl. Clrcu Innd County Courts D.C. 96836 13E6 1996 . AU6 14 09:57 Prepared by: •7 1,c erv s Address: 93S e)-CU. Ai //9l/ (. 34tGCb H STPEET. SUITE 202 RIGA 3O12e 4E. 1S) 2201171 �) SS4 -7622 7)i eu:1/ V- • • • - A /LT1(vC�7 `l� m �t1�FL �Ixt � *IL o� 0 SKETCH OF SURVEY Scale t "= 24 43 LAND SURVEYORS y o ' L./ ,0 .4 /130' 111 N• fz� 4,/t/b /O 80 2 . 4 \ d SURVEY NO. :24- SHEET NO. OF 2- 1 ■ 13,