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500 NE 95 St (2)BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE. FLORIDA ❑ PERMIT N? 12122 ❑ Bi. cONTRACTOR OR BUILDER BY 11 Subdi- vision Value of Proj ect $ ❑ Work to be performed under this Permit Amt. of Permit This permit is granted to the contractor or builder named above to construct the building or to l the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. / ...., �..., BY 1 r r ,) _ . INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. ■ t ,St ." 42.4eLXV BUILDING ❑ PLUMBING L o PERMIT N° 9376 ROOFING ❑ ❑ Work to be performed under this Permit Ale w /9 • " � Z1 I ,. , 7", Owner of A Building / /r / S C. L fiC 4, .74 /11-41 - / 1 Z e• r e C.. / .e • 4900 Architect or Builder Contractor v r i � � or Builde t.. e, (.c , . ;, .` , ‘ 4 :.. T/ O r(, 1c2416 Legal Lot i 'Z,, Subdi Description 1 T31 44,-- , ision /7/ et • f • • t,' / /tom' c �+ t Sq. Ft. Address of �/ W Value of 46 Building / ' L /// Project $ 440 This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with am plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the pJRir3• or drawings or in the statements or specifications and that he assumes respon sibility for work done by his agents, servants o emplo I Signed �' ' '%"f'r' (INSPECTOR) BY In consideration of the issuance to me of this permit I a ee to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, dra t gs, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work one by either, myself, my agent, servant or employee. CONTR TOR or BUILDER MIAMI SHORES VILLAGE, FLORIDA Date PJ ! ' 3 Contractor's 4111031t License No. Amount of �.. 11 Permit $ BY AUTHORITY INSPECTIONS DATE i BY RE- INSPECT EY RE- INSPECT EY FOUNDATION __. 5 i7_ 7.. `. ,, ,,i,a, PERMIT NO. DATE FEE TEMPORARY SERVICE _ SEAMS & LINTELS $ F P 1 f-1 i,NC S SEWER 5 SOLAR HEATER MOTORS FINAL 1 _ 5 GAS I $ i LLLAN -UP BY RE- INSPECT BY RE INSPECT BY ROUGHING CONTRACTOR PHONE PERMIT NO DATE FEE S NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ SEPTIC TANK S SEWER 5 SOLAR HEATER MOTORS 5 GAS I $ i INSPECTIONS DATE BY RE- INSPECT BY RE INSPECT BY ROUGHING DATE BY RE- INSPECT BY GAS BY TEMP. SERVICE SEWER SEPTIC TANK ROUGHING SOLAR HEATER, H. W. HEATER CONN FIXTURES RANGE CONN. CONTRACTOR PHONE PERMIT NO. DATE FEE $ NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. S MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. F & FINAL BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL. TO POWER CO. FOR SERVICE DATE BY OWNER'S NAME R.J. Comitog- PRESENT ADDRESS LICENSE NO. PHONE M />;‘,i' • • JOB LOCATION (ST. OR AVE.) 474 N.E. 95th St. LOT BLOCK SUBDIVISIO I GENERAL CONTRACTOR owner ADDRESS PHONE NO. LICENSE NO. +� QQ BUILDING PERMIT NO. 1 333 2 p DATE 6 -18 -52 PERMIT FEE S 6.00 BUILDER'S BOND NO. DATE ZONE R EQUIREMENTS CU. FT. PLAN CUBE 1884 CU. FT. EST. COST S 1,400 DRAWINGS, SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: DATE NEW CONSTRUCTION TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION REPAIRS DESCR IPTION • ALTERATION DESCRIPTION ' Y.slousie porch addn._ X ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COU IL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS C I — -- d. Sy \i -.) t - i ` 1 • ' CERTIFICATE OF OCCUPANCY NO. 1 946 ISSUED ("). a- S3 BY Vv TO 6 '�r,.�,e..,,,� BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date Sept 24 19 51 Owner's Name and Address __ lir &___ Mrs ___fi___V___Vi ly _____. No Street Registered Architect and /or Engineer _ Curtis E Haley Name and address of licensed contractor Ede Fitzgerald & Sep Location and legal description of lot to be built on: Lot. 12 Block -- -_55- ____ -- Subdivision Se_4tiaa__2___ Miami ___Sher_e$ '1 I , Street and Number where work is to be done State work to be done and purpose of building (by floors)_____ Dwelling , t.. _ and for no other purpose. New Building ___.__ 3C Remodeling Addition Repairs No. of Stories 1 Kin pf foundation Bleak Roof Covering, Wile To be constructed of C B S f7 - t, i t Estimated Total cost of improvements $ a _________________________Amount of Permit $ . ' Zone cubage required. 1750Q _________ Plan Cubage_ 5 _ _ y , , Distance to next nearest building - 20 ft Size of Building Lot 50x 128.50 4. Maximum live load to be borne by each floor 0- :: `_ 4. - I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to . ____ Eds__Fitsger_a.ld___ Sea The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on . .rk to be performed under this permit, as are licensed by Miami Shores Village. Remarks ___ _ (Signed STATE OF FLORIDA, I COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared — — — — to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that h(ias carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stat are true. i Permit No._ } 1_1 113ate x' .. Read, Sworn to and Subscribed before me. Disapproved ,_ Date I Notary Public, State of Florida (Signed) - - Building Inspector My Commission Expires PLANNING BOARD - DATE Cliainnan Member Member Member Member - Member Date Disapproved Date Council Approved NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. xelUDEr L t D A 181 E: - F t z. S 1 •8 J °' 0 S T - 14 • ° / ,qo e t i (1 ' ' 2 ,coo 17 Fi ieThL iLLGt R E: LE : ILit fiEtc H _12.9 151 1 ' e - c11 1 I LoT 12. i tlocx 'La'T • 11 icoo.o s. 1 4 s . 2. it it . . F_ l- UILDING PERMIT NO DRAWINGS. OWNER'S NAME JOB LOCATION (ST. OR AVE.) LOT GENERAL CONTRACTOR NEW CONSTRUCTION REPAIRS ALTERATION ADDITION 1 :'1 `_.. ZONE REQUIREMENTS CU. FT. PLAN CUBE SUBMITTED TO PLANNING BOARD RF•SUFMITTED TO PLANNING BOARD s,'PMIr TO VILLAGE COUNCIL DATE APPROVED REJECTED PRESENT ADDRESS ADDRESS PERMIT FEE S BLOCK j ■ rtr, SPECIFICATIONS. RESTRICTIONS ANDCUBE CHECKED BY TYPE STORIES ROOF CONSTRUCTION DESCR IPTION DESCRIPTION REFERRED TO COUNCIL CU. FT. REMARKS CERTIFICATE OF OCCUPANCY NO. - - ISSUED BY i TO BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE LICENSE NO. SUBDIVISION PHONE NO. jb Yv1,4- rBUILDER'S BOND "' 2 �. NN O. DATE EST. COST $ INTERIOR CONSTRUCTION REASONS PHONE NO. LICENSE NO. DATE INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION q -- a 7-1" DATE FEE TEMPORARY SERVICE $ BEAMS & LINTELS #O *"i 0P 1I . $ $ SEWER FRAMING /O ..q 5 cad.:( l $ $ GAS $ S $ $ FINAL Pa' .2i,S %W.1 RE- INSPECT BY RE- INSPECT BY CLEAN -UP IL $ k ROUGHING CONTRACTOR . U &J 6- .6-40.„ PHONE � PERMIT NO. r3 57 I DATE J/ f i' 41 FEE $ •y /; NEW BLDG. I ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ $ SEPTiC TANK $ $ SEWER $ $ SOLAR HEATER $ $ GAS $ S $ $ INSPECTIONS DATE B ( Y / RE- INSPECT BY RE- INSPECT BY ROUGHING i /.5-S1 '.((�I 11 p52 i ROUGHING GAS 0/4 H. W. HEATER CONN. SEWER 1 RANGE CONN. SEPTIC TANK SOLAR HEATER FIXTURES & FINAL FIXTURES , ' )- c - k l C . ( (i 0. CONTRACTOR -(Q.L.k PHONE � < j .� PERMIT NO. / OJ"� �S S I DATE J 0° V ° S J �/ FEES 9 NEW BLDG. I ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING /A- aC,- SI 0/4 H. W. HEATER CONN. 1 RANGE CONN. FIXTURES & FINAL /— a.- s)- J - ,I a � ING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE BY N9 1464 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla , -F 3 Owner, Agent or Tenant of Building Lot' Block Subdivision Street Address r ' Approved use by occupancy Remarks. This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known ss the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. BUILDING DIVISION ..VU 1N.. 'jjZn �ti. LEGAL I b .. jj ivy ,ec. a RECORD GARBAGE TAX r ADDRESS PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID NUMBER J.C.Edley 9 -26 -51 . II: Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement or i plans and specifications herewith submitted for the build ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the. Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progreu of the work. 7 Date..._......._._ _ __....... ,11�% Owner's Name and Address _I eetl.L � &el) r,5 ..,-.5 Registered Architect and /or Engineer........... ,,.,. VII ...,,,.,,,, „,,,,„,.,.,,,,,,,,,. Name and address of licensed contactor _ _ _._...._.......... Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where. work is to be done _....._.._..._._. __ sue! ✓.i��YG -/• HO Z. /4 � - ac-L6 •/146 i 4 f5 e State work � do e and purpose of building (by floors) - .___. and for no other purpose. Ncw Building Remodeling Addition Repairs No. of Stories / _ To be constructed of Kind of foundation Roof Estimate Total cost of improvements $ 4 . P.) Amount of Permit $...�t. . Cfr Zone cubage required Plan Cubage Distance .to next nearest building. Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to.. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of Labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in tkc work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or noticcs as are required by the Act. The undersigned agrees to employ only sugh subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. f ��� %lam 'G ”— Remuks (Sig STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true.. pp �� . ✓� 1 Permit No.._ D ..L. 1. f ` Date -) 4 4 — � Read, Sworn to and Subscribed before me. Disapproved Date .._.. Notary Public, State of Florida My Commission Expires _ PLANNING BOARD DATE Chairman Member Member Member Member .. .. _.....__....._..._._...._..._._ Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship. Application is hereby wade for the approval of the detailed statement o the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address - ....... /v / <�� Registered Architect and /or Engineer �+ 7 Name and address of licensed contrpctor..,G .' Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done , State work to be done and purpose of building (by floors) peared MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR SAJILDING PERMIT PIIANNINC BOAR* Date t: e / et Notary w ublic, State of Florida My e.3 :nr7 :..; :sic'& k a!, i^.'es -. ) A'(I< i = r . and for no other purpose. New Building Remodeling. Addition repair= 4 - No. of Stories To be constructed of Kind of founded Estimated Total cost of improvements $ Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction r,tay be sent to The undersigned applicant for this building pennit does hereby certify that he understancs and accepts his obligations as an employer of labor under the 'Florida Workmen's Compensation Act, being Section 5963, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all corera.ctors or sub - contractors emploved by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be per:urmed wider this pennit, as are licensed by Miami Shores Village. - Remarks (Signed). Ce— Zee Rocf Covering < Amount of F c- -. STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to adtnimster eat';s <: nd take a ^.knowledgreent.,, personally al). Chairman Member later :lbcr Member ...... Murree, Council Approved Date Jisrp, =ov €v to me well known, and who, being by me first duly sworn, upon oath deposes and says that he ie the. of the above described construction, that he has carefully read the foregoing application, r.nc ti - al ha; a ., ,fd sign the same, said that all facts �� Permit No m sta are true. Date / 1 Read, Swo n t0 c..rtc Subs -ribcd befo.e me. Disapproved ` Date (Signed) ( Builciltg Inspecto Date NOTE: A charge of $1.00 will be made for making correctiora, naa:rg.:s .n "`:s nx.: after a pproval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such rein ectior :gas ' by noItec fee inspection or faulty materials and /or workmanship. N° 1464 Lot 1 ° Block Street Address C CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla , Owner, Agent or Tenant of Building Subdivision Approved use by occupancy I Remarks: This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known a s the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. BUILDING DIVISION MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing oz other structure herein described This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village. Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. /- Date Oix al is Name and Address _ -•- -. �.. .,-- No. Street Registered Architect and /or Engineer _ Name and address of licensed contractor_ _ _ _ . c" , Location and legal description of lot to be built on: . Lot- Block l 1 �'�� � _Subdivision Street and Number where work is to be done STATE OF FLORIDA, COUNTY OF DADE. ss. /V) r Sw. feat, State work to be done and purpose of building (by floors).. 1 and for no other urpose. New Building Remodeling._ _____ ___. Addition ._ __ Repairs No. of Stories - _ -' To be constructed of Kind of foundation___ Roof Covering__ A'n= --? Estimated Total cost of improvements $ - " I - Amount of Permit $ 1C -------1 Zone cubage required plan Cubage _. Distance to next nearest building._. ___ . _ _ _ Size of Building Lot Maximum live load to be borne by each floor___ I hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may be sent to_ -- �-- -- The undersigned applicant for this building permit doe hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen s Compensation Act, being Sec :ion 5966, Compiled General Laws of Florida, Pennanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks__ _ __ (Signed) Before me, undersigned authority, a notary public, duly authorized to administer oaths and take a:knowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him s d are true. Permit No 3 C Date.. / Read, Sworn to and Subscribed before me. Chairman Member ________ _____ _-- Member . Council Approved Disapproved ____ _ __ ____ _ Date (Signed) � Building Inspector NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. PLAN NG BOARD_ Notary Public, State of Florida My Commission Expires__ DATE Member Member Member Date Disapproved Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date V7 97 Job Address ,5 ' 7 't ' f . Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant ■ /Xtj*j J , 0f4/,/®,,5 Master Permit # Owner's Address / /G' j//?1 '' .84/17/7 Phone Contracting Co. ,4 / 'A) J /1) 7 Address I 2- / fG✓ /az 4 2 Qualifier 4 ,_l .o J7 State # Municipal # Competency # /3 3 7 / Ins. Co. Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Address Address SS# LPhone Square Ft. 5 ' Estimated Cost (value) 6Z 9 Y 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. C`1VNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be do e in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the wor stated. Signat e of own and/or Condo President Date Notary as to Owner and/or Condo 'rests - My Commission Expires: FEES: PERMIT e (e .) . RADON Date APPROVED: Zoning Building tit Signature of Contractor or O er- Builde ate Electrical A )96 av�_ /J Notary as to Contractor or O er- Builder Date My Commission Expire C.C.F. .• ) NOTARY - BOND TOTAL DUE Mechanical Plumbing Engineering