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518 NE 94 St (10)BUILDING ❑ ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building ' t 1,.--PERMIT 'N° 11312 dONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE' 195 Contractor's License No Work to be performeditnder this Permit Subdi- vision ^ "Z 7 Value of Amt. of Project $ Permit $ f 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 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 contpor 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. BY AUTHORITY Signed • > it'' INSPECTOR In consideration of the issuance to me of'this permit I a% a tb 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 &the by either, myself, my agent, servant or employee. BUILDING ELECTRICAL PLUMBING ROOFING MIAMI SHORES VILLAGE. FLORIDA El PERMIT N° 5975 Owner of Building Architect Contractor or Builder Legal Lot Description — Bl. Address of r Building CONTRACTOR OR BUILDER Work to be performed under this Permit Subdi- vision Value of Project $ DATE 195_ Contractor's License No. i 1 - Amount of Permit $ 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 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. 1F ; Signed. 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY Permit No 15/ 67 0 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date 3/11/ ?? Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oi other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu:ida, 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 work. . beko Owner's Name and Address Employing Electriciati's Name 1...0 YSCV\ Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling 1 2 •.b Overhead Service untlertfeeed Size Feeders Conduit - Main Sw /4D of Installation — Conduit Tubing B.X.L .Metal Moulding Amount of Permit $ No "`Q4CI (Signed) No )17 Street T4 5 Block Subdivision n' 74sr Registered Architect and /or Engineer Street Street n f'' ro`.l. Ter r' ,,5" t ncve se_ wi ri hd.s. Cc- &t .( A fe Addition Repairs No. of Stories /St!' 4. Amps Main Fuses /6 • Amps (Signed) Elea 'cif Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati° as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per ent 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. E Muter Electrician. STATE OF FLORIDA, COUNTY OF DADE. f a Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to Inc well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for Inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO LAMPS REIRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER H W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHICK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST / —04∎ 3 5© /.' #P CHICK te Permit No 15/ 67 0 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date 3/11/ ?? Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oi other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu:ida, 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 work. . beko Owner's Name and Address Employing Electriciati's Name 1...0 YSCV\ Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling 1 2 •.b Overhead Service untlertfeeed Size Feeders Conduit - Main Sw /4D of Installation — Conduit Tubing B.X.L .Metal Moulding Amount of Permit $ No "`Q4CI (Signed) No )17 Street T4 5 Block Subdivision n' 74sr Registered Architect and /or Engineer Street Street n f'' ro`.l. Ter r' ,,5" t ncve se_ wi ri hd.s. Cc- &t .( A fe Addition Repairs No. of Stories /St!' 4. Amps Main Fuses /6 • Amps (Signed) Elea 'cif Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati° as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per ent 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. E Muter Electrician. STATE OF FLORIDA, COUNTY OF DADE. f a Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to Inc well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for Inspection, or faulty materials and /or workmanship. Registered Architect and /or Engineer.__. _.., MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No c t Date `1 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work Employing Electrician's Name. , rig '''''— Ae F ' No...,f. Street. ,r Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Owner's Name and Address... J 61 -C - tikwec 4 .4/ Street Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (Signed) Electrical Inspector. 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 subcontractors 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 sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. I S S. (Signed) Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR.. LIST ` (0,01% CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Registered Architect and /or Engineer.__. _.., MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No c t Date `1 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work Employing Electrician's Name. , rig '''''— Ae F ' No...,f. Street. ,r Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Owner's Name and Address... J 61 -C - tikwec 4 .4/ Street Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (Signed) Electrical Inspector. 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 subcontractors 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 sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. I S S. (Signed) Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No. Location and Legal Description Lot MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date / °�� Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 pecified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address - � i 14 _(�' e/,�_12:1 C? _ -- -� - -- _ - - No r _l. __. Street_ , —_') Registered Architect and /or Engineer Employing Electrician's Name __��%?- ��!��� � � � -� :�1:.•�io L 9 Ve � Block - ) Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition.. Repairs Street V Street__L ✓ ____/ Subdivision__ __ I/o. of4tories Overhead Service Size Feeders; _J Conduit. __ Main Sw __ Amps. Main Fuses_ .Am s. Underground p P Type of Installation—Conduit _____ ________ Tubing __ B.X.L Metal Moulding Amount of Permit $ _• Electrical Inspector. 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 com- plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. ss' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. My Commission Expires (Signed) (Signed) Notary Public. State of Florida 'Master Electrican. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'8 FIXTURES NO.LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL C LeT R o o �J ap 4 G ,. ` � O/ � 7 .r-� / / L D o7 5 f 0 e " - , CHECK � R o ?° r_ss ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PER MOTORS 0.1 HP MOTORS 1-5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK 4 Permit No. Location and Legal Description Lot MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date / °�� Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 pecified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address - � i 14 _(�' e/,�_12:1 C? _ -- -� - -- _ - - No r _l. __. Street_ , —_') Registered Architect and /or Engineer Employing Electrician's Name __��%?- ��!��� � � � -� :�1:.•�io L 9 Ve � Block - ) Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition.. Repairs Street V Street__L ✓ ____/ Subdivision__ __ I/o. of4tories Overhead Service Size Feeders; _J Conduit. __ Main Sw __ Amps. Main Fuses_ .Am s. Underground p P Type of Installation—Conduit _____ ________ Tubing __ B.X.L Metal Moulding Amount of Permit $ _• Electrical Inspector. 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 com- plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. ss' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. My Commission Expires (Signed) (Signed) Notary Public. State of Florida 'Master Electrican. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No Date... ‘, Z 0 Application is hereby made for the approval of the detailed statement of the plane and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv :ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation's 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 wor et/0z �/ ^/ /��� Owner's Name and Address ... L...Gs. . / / ... t' �` � � No/ o Street 5T Registered Architect and /or Engineer E ploying E ectrici ' Jr / a cation an Le escnption Lot /e GG Block --S7 Subdivision 1 %-C " 0 . Street and Number where work is to be performed —No 5/ S .... /'Y:.„ r }T Street State work to be performed and purpose of building (By Floors) New Building Remodeling Le"' Addition Repairs No. of Stories Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- Conduit Tubing........ B.X.L Metal Moulding Amount of Permit $ Electrical Inspector. 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 subcontractors 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. STATE OF FLORIDA, } COUNTY OP DADE. ss ' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT .1.91:!'1...477 /6 ' f GNo..,r z5/ 5.W Street .7 ° �V/''' . (Signed) M` r Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re•inspection fee of $1.00 will be made when such re•inapection is made necusary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH 0 LIGHT OUTLETS PLUO RECE'P'T'5 FIXTURES NO LAMPS REIRIO. OUTLET IRON OUTLET RANG[ OUTLET RANOt CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP H TOTAL CONTR. LIST d // CHECK ENT. Sw. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTOR{ 0.1 HP MOTOR{ 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No Date... ‘, Z 0 Application is hereby made for the approval of the detailed statement of the plane and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv :ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation's 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 wor et/0z �/ ^/ /��� Owner's Name and Address ... L...Gs. . / / ... t' �` � � No/ o Street 5T Registered Architect and /or Engineer E ploying E ectrici ' Jr / a cation an Le escnption Lot /e GG Block --S7 Subdivision 1 %-C " 0 . Street and Number where work is to be performed —No 5/ S .... /'Y:.„ r }T Street State work to be performed and purpose of building (By Floors) New Building Remodeling Le"' Addition Repairs No. of Stories Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- Conduit Tubing........ B.X.L Metal Moulding Amount of Permit $ Electrical Inspector. 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 subcontractors 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. STATE OF FLORIDA, } COUNTY OP DADE. ss ' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT .1.91:!'1...477 /6 ' f GNo..,r z5/ 5.W Street .7 ° �V/''' . (Signed) M` r Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re•inspection fee of $1.00 will be made when such re•inapection is made necusary by improper notice for inspection, or faulty materials and /or workmanship. PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date Job Address 5 /9 LI/•F- 9y ' Legal Description '1 ® ,5 9 4/fi, Owner / Lessee / Tenant Owner's Address WORK DESCRIPTION 'ERMIT FEE: APPROVED: Contracting Co. (1?.. 0 - eoy�re e Qualifier State Competency # Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING 4otary as to Owner and /or Condo President zy Commission Expires: * * * * * Address .5 Z© Lf'c) / ` #, f�5'4 e2 3 )o /5hsh SSA Phone % 7 //9>y Address Address Address E C RI PLUMBING MECHANICAL PAVING FENCE SIGN Square Ft. Estimated Cost 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 iao the work stated. Signature of Owner and /or Condo President Signa a of'Contractor or Owner - Builder Jate: Date: -CP 4/ tary as Commiss * * Tax Folio �J .F /06 /4( Ogle Master Permit #23 Phone .51.9.9.7 7 1 ns . Co . (77`4 Ocs Z4rdi to Con r 9wner-Builder ion Expires: if ///9. * * * * * Fire Other Zoning Building Electrical 40P0191/( ( Mechanical Plumbing Engineering