535 NE 95 St (2)PERMIT APPLICATION FOR MIAMI SHORES VI.
Date L 07 Job Address '6 &` /v � l s / Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant 7T Al is v' / ) Master Permit # L-4. l (/O L 3
®
Owner's Address n� Phone �
Contracting Co. /� A /' Gc,�/4c - �.v//2X' «� S Address P�✓� A/1--r / f 5 7
Qualifier AA-rZ ( 44 7 SS#�6y -elk SJlL Phone - 7 ,5 ` ~
State # J Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
% , 1 i i r . 1-4-cA. M * .. was cc t A R oAR 0
(value) /t,5�
Estimated Cost
WORK DESCRIPTION ?/7...--,55 (.4,/fe
Square Ft. 0 2 ) vdCr
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: . certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
and zoning. Furthermore, I authorize the above -named contractor to do the k stated.
d/or Condo President
laws
ii
t, ating c. s /; '
_ ifi Atli
Notary as to Owner and/or Condo
My Commission Expires:
FEES: PERMIT 4 RADON
7
C.C.F. NOTARY BOND
APPROVED:
Zoning Building
Mechanical Plumbing
7pir)
Signature of Contractor or Owner - Builder
Notary as to Contractor or Owner- Builder Date
My Commission Expires: /
Electrical
1 /A
C871
TOTAL DUE
Engineering