773 NE 95 St (2)APPROVED:
Date / Job Address
Legal Description JOT /7
Owner / Lessee / Tenant
Owner's Address
Bonding Company /
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
0'
Contracting Co.
•773 NF, 75 St,
Permit Type(circle one): BUILDING
i ✓e - - y Grp 7' /a.7 7 4, 4' 4
r and /or Condo President
Signatu
Date:
Notary as to Owner a':�
�4QNa r � �• Public
My Commission Expires: State of FI• Ada
My Commission Expires 5/29/95
FEES: PERMIT .- RADON
773 NF 7.5' Sr Tax Folio 1/ 3a15 /y ot/6
/L'7 d
ELECTRICAL
P� /L of 7 / /oci 6; / aoi SA:ye.s -Cec r d, 3
Address
Estimated Cost(value) X /Sd
Da Lre :
Master Permit #53,1/3
Phone 75 7 - /873
Qualifier T/ylP.s Z4CI SS# Phone ,90 -5.000
State #(6 6050t15 Municipal # Competency # Ins .Co.
Architect /Engineer Address
Address
Mortgagor /Y /i9 Address
PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 2 / . � e Zyc i' %/' /c "al Verr O4
Square Ft. g0/
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 �a above -n• =• contractor to do the work stated.
Sig p ure of Contra for or Owner- Builder
Notary as to Contractor or Owner-Bu Eder
My Commission Expi Bum Fernandez, No -•♦ Public
State of Florida
My Commission Expires 5/29/95
* * * * * * * * * * **
C.C.F. ) 16 6 NOTARY TOTAL DUE (
Fire Other
Zoning Building 1 Electrical
Mechanical Plumbing Engineering
8699
LEGAL DESCRIPTION
Lot 17, and the East 1/2 of Lot 16,
Block 68, "MIAMI SHORES SECTION
NO. 3," according to the plat thereof
as recorded in Plat Book 10, Page 37
of the Public Records of Dade County,
Florida,
3
INIERt.ocJi*.
BR14K
1 ....,44-14;.Y ^• - 753 10 44
-
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SKETCH OF SURVEY
2 ; r:C%
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2 . -C . ti ,.
APPRAISAL DEPT. MSP; APPROVAi_
(homes completed over six months)
Appift• -�ti n No.
Survey conforms to appraisal:
Legal description
Bldg. & Lot dimensions
Conditions before closing
• Obtain titki insurance
r •
Approved by