518 NE 94 St (9)- 7 -` �
Date 3 Job Address 5/ X 4 5
Tax Folio // ja04; /5/ G,4,r!9 C1
/ 570 RI4 / S/ ara's
Legal Description
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Lessee / Tenant 0ra
( 1 1 •`i" f s'eR„� JCa ��,r s Master Permit # 33
Owner's Address s1 S �k 4 Q v
Contracting Co. Oile - CMS4VG(.40/
� S L& 3
Qualifier b Cock SS# 7 -4441
State #66(035 iC Municipal # Competency #
Architect /Engineer
Bonding Company
Mortgagor
WORK DESCRIPTION
Square Ft.
Signatur
Date'
APPROVED:
4
Zoning
PVRMIT APPLICATION FOR MIAMI SHORES VILLAGE
N��
nd /or Condo President
er anLnr •••• 'resident
Notary as to
My Commission Expires am r.. "^.. STATEMPUDDIDA
1 lip COtatisSION EXPNOV. 3,1996
DOMED n>au MEW. ma. UND.
9
** * * * * * * * *
Address
Address
Address
Address
at
Phone
2 D A3 E L AU-P_
ture o Contractor
7 452
Ins . Co .
Permit Type(circle one)(BUILDI GN ' ) ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
- 1-4∎5 .1 l �4r l ®c .t r . k acv e.�r5 I A
S �'
A* C 1 vQ._ LAD c ,
Estimated Cost(value) 5. 4 1 ;o 71 0
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 accurate and t< h a 1 work will
be done in compl � ce wit ; /all applicable laws regulating con tion , /nd ning Fjthermore, I
authori - h. ' s nam, .,contractor to do the work stated.
r- Builder
i c 1 1r
gip if / //j 1 J / /it1 _ Y / / /sue
Notary as to ontractor or Owner -Buil
My Commission Expires'
WOTARH PUBLIC, LIC, STA• E O7 GLUM. o
MY COMMISSION EYL HITS: lacc. 2 ",
BONDED TRIM NOTARY PULL ' 7=-t - kl ,
* * * * * * * **
FEES: PERMIT a RADON C.C.F. "4 NOTARY TOTAL DUE W'IC
Fire
Building \'' ' °� Electrical
Mechanical Plumbing Engineering
Other
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TEUIPNONE: 44471192
LOCATION SKETCH SCALE 1"
J
T r T KELLY, 1C SURVEY NO
12,4[31
LAND SURVEYOR
SURVEY OV1 1!6 _
IVISION MIAMI ‘si1{C7
ACCORDING TO THE PLAT THEREOF AS RECORDED K No.
PUBLIC RECORDS _ _F COUNTY, FLORIDA.
DATE: "p ti. �� . ,; , FOR:
Cs'pr/c/6 7o
,4'2 /ij 6
Ave yd f'! Fmk/
SHEET
,Z
OF Z
BLOCK '7 !_ -•
AT PAGE No. i
Fr LE ►_1O -
ynr/t: -N t( (,jQ• - 1)
THE F.LA. IF;' 2 ,,NrE RATE MAP, CA E?
SE P. SJ. ;'i.':: (;U ?E. :"CD MARCH 18.
1971 T'•: : STATE
DEPARTMENT OF H:)t,l ;i;;"; ',ND URBAN
DEVELOPMENT D_! (:Cr .,.. i:: HfREIN
DE:. LAND TO BE S1Tu Ej ti ^„Tii
ZO;■E.
IS A FLOOD HAZAR1)
ZONE.
OALUJ r PAPAITS • su° ..
I hereby oatify stet this sketch of survey ei the ett+ove deearabed property ie true end carect to the best of my knowledge and behot .(•
recertify tsun eyed and platted under my direction. I further oerttfy Ntet thip sasivey meets the minimum requirements adopted by th
F lorida Society Qf Profess' al Land Surveyors and the Florae lend Tit*e Association There are no encroachments. except as shown
PAL N 2/ HN - G F. C 00
Notes: 1. If shown, bearings are to an assumes" meridian /rr/
dEORGE18A to 2. h Chown, elevations aro referred to N.G.V. Daturr,'
S r 3 THIS f5 A L 5UR� Y
OCT Shift Ftwiele
VAUD V&ZY! ISIPAIIMID MIN Ate €MBO$SEO £1. *!VOWS WA 1
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