1201 NE 94 St (7)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Jew ty
Legal Description
er / Lessee
Owner's Address
Job Address , 2-01 auG 9L/ S�'�e Folio
/ a 0 I' /lf (s 57741 7
/ Tenant / "� Brim#) Master Permit 46
0-0/ q 51v-e--4
Contracting Co. 5.N/, PC10l.-S l -I-'r Address JX 3r /V) fx/E hl-by
Qualifier D 4. ' tt _ CS'S' f `/ Phone e l1i f f 0 001
State # O Z IOSMunicipal # Competency # Ins.Co.
Architect/Engineer Address
Bonding Company //i' Address
Mortgagor / Address
Permit Type(circle one): :UILDI► ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION s ,1�D a /i4" si 14 / `
Square Ft. P001 6) s* Est Cost(value) I a 0 a
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
be done in compliance with all applicable laws regulating co
authorize the above. arced contractor to do the work state
Signatur
Da
D. A. ( CIAL NOTARY SEAL
Notary as to Owner an r afaN E NU BER
My Commission Expir-s: 0 ; CC009512
** *
APPROVED:
Condo President
MY COMMISSION EXP.
OFF JUNE 1
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Signatur
Date:
air
Notary as to Contr
My Commission Expi
Fire
Zoning Buildin
Mechanical Plumbing
Phone
curate and that all work will
n a': z• ing. Furthermore, I
5F
My comm Exp8/29/95
BONDED
er- Builder
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FEES: PERMIT vt //C RADON C.C.F. 14/ NOTARY TOTAL DUE 52,11
Other
Electrical
Engineering
J NQTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO.
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:
2. Description of improvement:
3. Owner(s) name and address: tit/ 4; at VA -I-M.
110 t � f VV2•et / M 1 1 S iaCd i
N/14
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
AI/4.
Ve TN.;
7. Persons within the State of Florida designated by Owner upon whom nofiiges'a
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 specifie
Signature of Owner
Print a ers Name M _' ( k , )3 R A 1 )
PO L 1
:go 1 IJ-q. 4-fl
r fff I4 sHo ;t9
Sworn to and subscribed before s. - this l5day of JAIJ , 19 q (T .
Notary Public � _ � ,
Print Notary's Name �
My Commission Expires:
94R033190 1994 JAN 21 11:33
�
PI /4& OFFICIAL: $ NOTARY AL
= 11 .it f' -. YARCIA E>lIEIO
CC009312
MMr3$ION EX .
-Fly
--JUNE 1 19
•
STATE OF FLORIDA, COUNTY OF DADE
1 NEJE' % Cq, ?' ;i % f'
^a' this is a Moo copy of the
41•19....1
By
t rci.; Se .4.
tt1Er, ftc e,rlts ma
Prepared by: � r 4iS ' 0
/83S 6J ,0/11/E1 ".
Address:
rved as provided
Jolty courts
o.G
12301-
Legal Descriptions 4:4
t Owner / Lessee
Owner's Address
WORK DESCRIPTION
r ),/
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date j . 7 �'a Job Address /_H2 / A/4 `2'% ' Tax Folio 1/ >< / ( V/( 5
/:,)_S'
/ Tenant
d/
g/71
Master Permit IP OW,
1
Phone 917 Z(k
Contracting Co. Address
Qualifier li 4/L SS# - - Phone
State I'i Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
`31 /er'/) /mil i ark- �./�'G � �7//� /'i- 1j -ere /r
Square Ft. Estimated Cost(value) " &G
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
50 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 wit all applicable laws regulating construction and zoning. Furthermore, I
authorize the above -na c. .tractor to do the work stated.
Si _
Date
• .• nil. C � .
• . . •
ary
or
s to Owner and /or
resident
.0 " " ",,, • JOSEPHINE CHURCH
• ;Notary Public, State of Florida
• :M April 30.I
o n
I4t545
CI
APPROVED:
Zonin
r and
RARPn ${- 1 Publi
Personally known OR Produced I.U.
T) pc and number of I.D. produced:
** * 1—'* * *
DID take an oath or
F A4 I 1 F ,?5`1)
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RADON C.C.P. , _✓�'
Fire
Mechanical
Buil n� Electrical
Plumbing
Signature of Contractor or Owner-Builder
Date:
Notary as to Contractor or Owner - Builder
My Commission Expires:
* * t *
NOTARY a �d
Other
*
Engineering_
TOTAL DUE 0 C'C
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