401 NE 95 St (12)Signature of owner and/or Condo Presi
iOEL BRODER
FEES: PERMIT
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date A Job Address 6 40 ( A 1 � � S l Ric F lTax Folio
Legal Descriptic,. Historically Designated: Yes No
Owner/Lessee / Tenant s 1 A ) t > ) 3v4t C Master Permit #
Owner's Address 4o i P Gs 5 Al. ;-d o Am o 1' e4,1% Phone a 9
Contracting Co. OA rd t itl a4 Fe 4 CI (ti Address 661 i 00 i a r ° kill , 3 `t7 8
Qualifier ii,,6 A- I y p c SS# ' - - Phone 7 i 7 h I Cc
State # Municipal # t e 0 Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 4 L' rid ➢ n L 1 itc t—ebi es,e,
Square Ft. 0 L r Estimated Cost (value)' 11.‘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 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.
9 A
IG3' RItIb 014 t tl Date
nded By Service Ins
No. CC534717
(] Pennelly Knows t ] Otbe L D.
RADON
N
My
tai 1 10(1
ppeasIes1 By Service lna
„ No. CC534717
Wrenosally Known t I O4e L D.
gip 3 /7
C.C.F. i NOTARY TOTAL DUE /7
Date
APPROVED:
Zoning Building Buildrn %
1" Electrical
Mechanical Plumbing Engineering
.14
fo /,3`' 'VZ,/_
PROMPT
PROFESSIONAL
SERVICE
CARDINAL FENCE COMPANY
661 N.W. 111th Street
MIAMI, FLORIDA 33168
(305) 757 -8165
FAX (305) 757 -9046
JOB 1( OdY4 Yes t jj Dst C 1we,h
SHEET NO 401 Utl I^� 95 (� J�° OF t,
CALCULATED BY M G4 O fl ° Il6 ve y DATE `� o
CHECKED BY DATE 5C'.? 9 a9 6
SCALE