358 NE 94 St (9)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
3 5 8 t�.0 Y ,
Date Job Address V6 q A Tax Folio
Legal Description Historically Designated: Yes No X
Owner/Lessee / Tenant/ 6474/' kVA (7 / * • Master Permit # `�� G / L1
Owners Address Phone'' � �•7 51 -�00 (o H,.../,
Contracting Co. Address 3S ive 9' c( Ste` .
Qualifier SS# - Phone
State #
Architect/Engineer
Bonding Company
Municipal #
Competency # Ins. Co.
Address
Address
Mortgagor Address
Permit Type (clrele on BULB ]ELECT
WORK DESCRIPTION • e ('g—
Square Ft. 2 �O.O0
Notary as to Owner and/or Condo President
My Commission Expires:
FEES: PERMIT
APPROVED:
Zoning
Mechanical
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE T DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO Y'.UR PROPERTY (IF YOU INTEND TO O,,,TAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTIICE OF COMMENCEMENT.)
Signature of owner and/or Condo President Date
RADON C.C.F.
CAL ]PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Building lk � J
y .
Estimated Cost (value) ( 1'..9 . O O
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.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be do ompliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
AL
•, • •
AL fir
•
//
gnature
r
0
es: 0. FR «'T •
GLADYS 1 V1LLAE
CO�B�'S1ON NO tvA
cCC91
MY COMMISSION EXP. 1 002
S
Date
Date Notary : to Contracto
My Commission Exp
NOTARY
Electrical
BOND
0 6/1/ 6 ° oo
3 - z ?
TOTAL DUE
it/
Plumbing Structural Engineer