ALARM SYSTEMPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date /A60b Address ( Z‘ il Q7/'
Legal Descriptionet cj 8 Master Permit # LVe'4)
9 / L �s
Owner / Lessee / Tenant V . etevich
Owner's Address Phone
Contracting Co. Address
Qualifier SS# - - Phone
State# C 610 S 8
Architect /Engineer
Bonding Company
Mortgagor
Square Ft. .0
Competency# Ins. Co.
i neze('(c// e( � Address &/ kieke44
Address
Address
Tax Folio /goV i 7 ✓ rd
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION td </ 4? t ,,,I Me `/- 34'e .Ez/ccs-
Estimated Cost 6Y.
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 do in compliance with all applicable laws regulatin: construction and zoning.
Furthermo e' authorize the above -named contractor to "do the woe tated.
Signature o
Date:
Fire Other
f 0 ner and /or Condo President
/fie I 0�.9 �G4L env"
lot as o Owner and /or n President 1 w
V • mmission Expires: 1//$1,/ o
r
Commission Expires: s to Contractor o O er- Builder
7k �Ic
o * * * * * * * 1 * * *
'ERMIT FEE: APPROVED: W t q
R
•kQ Zoning Building Electrical / 'N 1 1
re, /,• chanical Plumbing Engineering
tor or Owner- Bu3,.ider
Date
1ERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
V Job Address �/ `a a Tax Folio fQw/y Jf
Legal De'scriptioncC a '
Owner / Lessee / Tenant
Owner's Address ,' Phone
Contracting Co. � � Address `
\ �'
Qualifier _ SS #. - - Phone v - - 0 ' 4
State# .v , .. Competency# 1, ?4 i/ —Ins. Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION __ \ _ - A • \
Square Ft.
t
Signa ure of Owner and /or Condo President
Date:
x xce
7
Fire
Building
•
Estimated Cost
Signat
Date t6 9/
Master Permit #
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 re: ating construction and zoning.
Furt oe, I authorize the above -named contractor to do ork stated.
c-
•
Contractor or Owner - Builder
C,4 41. .} Z.sy 4/
N tar as to Contractor - 97 wn - Builder
My Commission Expires: ! f/ t
Notary as to Owner and /or Condo President
My Commission Expires:
)4- LI *
PERMIT FEE: APPROVED:
Zoning
Mechanical Plumbing Engineering
Other
Electrical
; •Qc■N J x'44 fir_ V: c V
\ ; M 5‹.* I ��2CCt
(P■: !-t o y C
e
C 41
TIESE PLANS ARE APPROVED FOR
ISSUANCE OF A BUILDING PERMIT
VARIANCE(S) LISTED IN "REMARKS" ,s
MIAMI SHORES BUILDING AND ZONING 1 "
UNLESS SPECIFICALLY LISTED BELOWP i
AND COUNTY LAWS MUST BE COMPLIED -,
Autho'i =e1 S gn^ture Date
IN WITH NO VARIANCES • •'WITH
NO OTHER DEVIATIONS FROM 1HF..
ORDINANCES WILL BE PERMITTED.
ALL OTHER APPLICABLE STATE
WITH BY ALL PARTIES.
FIRE DEPARTMENT
PUBLIC WORKS
POLICE DEPARTMENT
BUILDING DIRECTOR
1/ A
PLANNING & ZO;:ING :70 '
VILLAGE COUNCIL
APPROVAL
PRELIMINARY: FINAL:
REMARKS:
COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED
BY MIAMI SHORES VILLAGE IS REQUITED. T„E ARCHITECT, BUILDER &
SUB CONTRACTORS ASE r"i': ■nP. i' ' OW! ErICE nF n r 11.!1! D-
ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN.