315 NE 95 St (5)Date
permits
OWNER'S
be done
authori
Legal Description
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 5 lc Of 55 5 . 1
/ Lessee / Tenant MAJOI G v zevt 1
Owner's Address 3 fl e N1 s k-torve
Contracting Co. Fb�
Qualifier (CZ/
State # Municipal # Competency # Ins.Co.
Architect /Engineer ce4
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN FENCE SIGN
WORK DESCRIPTION _ ���.ir /�� /L �% /
Square Ft. 7 / Estimated Cost(value) 3qQ / t
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
are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
FPIDAVIT:
n comple
SS4
certify that all the foregoing information is ac
ce with all applicable laws regulating construe io
ove -named contractor to do the work stated. 11 . + 414
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
Address
Tax Folio/J 5g OG.✓ f' 600
Master Permit #
- - Phone
Address
Signatu e
Date: 7f
Print type or stamp name of Notary iyuhlic
P er onally known DOR Produced 1
,44 , .�a "i u .o and number of 1 D produ ced:
ota�ry as to Contractor or a,
y Commission y �[�kc an oath, or
DID NOT take an oath,
to and that all
}},,wwork will
" EPHiffes R rmo 1
Notary Public, State of Florida
My Commission Exp. Apnl 30,1996
• No. CC197545
** * * * * * * * * * * * * * * * **
FEES: PERMIT ; RADON C.C.F. 1 „5 1 6 NOTARY SZE:20 TOTAL DUE 3
APPROVED: Fire Other
Zoning Buildin 0 / Electrical
Mechanical Plumbing Engineering
i d ,
� e
:Cr. u5 `. t�'..
P9gsc , .
o�
1.‘ ' r::::11.,„
+
1
1
Fix: Bk ¢
.
,
6 ' ` : -'�
`_
.- -_
.NsrtiT
cveft ... : -"
:_ -..
..2.6
-.. -
0
-1 3
tT
T P,n 6) /+ c -I,Ove f) i n CcM
Salo a3
Bhe
y s p ce_ V\ ous.e
scrtA c)
a&I (10\1,,‘ LA)c-4
To G.A
L.i A WoR ot2 kiGvse
ci s vi yx y ?h
tA- t ICE vo, \ks k l4 ,,k
3 ?/- 589
315 fl 9' S s T 1Y\ laitit S HOOPS f' to