253 NE 94 St (6)1Perlmnit Type (cringe one):
My Commission Expires:
FEES: PERMIT
PE MET A IIDP IICATII •N FO
IL
Signature of owner and/ca Cam President
Notary as to Owner and/or Condo President Date
RADON
C.C.F.
6.0
eq
MIIAIiiIII SHORES VIIIL]LAGF
Date )/ /0 0 Job Address 94-14 l Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant O 0 At (°St E ( P S7UGf (/ 4/
Owner's Address Pho e 1 Sz<- L 9 6
Contracting Co. r Address g / N : L ( 4/-14\ -
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
IITIILDIINO ELECTRICAL ]PLUM I: IfN` Q MECHANICAL ROOFING PAVING FENCE SlI N
WORK DESCRIPTION v�t t l l h 6 r (Yi Orittcl AOC?
LA--th t P
Square Ft. Estimated Cost (value)
WARNING TO OAR: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR 14llP OVEMENTS TO YOUR PROPERTY (IF YOU II1:T1EN D TO OBTAII•I FINANCING, CONSULT W1[TIFII 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.
Date Signature of ontractor or Owner- Builder
NOTARY
!G`
Notary as to Conte
My CO — S"Xr)ll�S' _ _
0FiC1Al OOTARY SEAL
`p U ROARITA WONTIEL
SS@ y y.j
ti til '•' iC � /s(O
=
f1EC. 17,200
M
Master Permit #
Electrical
tor or Owner- Builder
[dY
� l `' OF F1.
BOND
TOTAL DUE
No
Date
-/ - -O
Date
3 - 1 -v
' S7 - F �2
■
S
APPROVED:
Zoning Building
Mechanical Plumbing Structural Engineer
99
1 r .. �,r
Owner / Lessee / Tenant 'PCo�� �,� � ,z5 ,r{ �c Master Permit # �"/ ��
Owner's Address
Contracting Co. Oto A . 3 �2 Address 3 33 Vs
Qualifier SS# 03,5 - 3 g - S3al Phone 75 k ,3O
State # Municipal # Competency # Ins .Co .
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING M ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
�— X ( L 2 i v ` i •� . � nl�
Square Ft. Estimated Cost(value) Z.S 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 cent at all the foregoing information is accurate and that all work will
be done in com.liance wit .1; a rlicable laws regulating construction and zoning. Furthermore, I
e above - ame •. r:'tor to do the work stated.
Signature of owner and /or Condo President Signature of Contractor or Owner - Builder
Date : f/c11/ ��
Noary as to Owner
M Commission Expi
** *
FEES: PERMIT/7'476
APPROVED:
Zoning
QII'II' APPLICATIION FO MIIAEY1MII SHORES VIILLAGIE
,d d ress ?_ S 3 /J E `l sT
2�3 ,43e c r�l sT
tr * * * tz * tt **
RADON C.C.F. ch O NOTARY , ro D' TOTAL DUE q'g' o
Mechanical Plumbing
Al , S L._ Phone 75 ( 30
Date:
Tax Folio/ 1 ' 14 1 1' J 6
Notary as to Contractor or Owner- Builder
My Commission Expires:
Other
Electrical
Engineering