912 NE 95 St (6)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address
Legal Description
Owner / Lessee / Tenant
State# 12842
Square Ft.
Signat
, Date:
My Commission
*. *
PERMIT FEE:
5 o. ep
5,oee
3l•5
912 NE 95 STREET
Qualifier DENNIS NEVILLE
0
400 SQ FT
Zoning
Mechanical
'RICHARDSON
Owner's Address 912 NE 95 STREET, MIAMI SHORES 33138 phone
Contracting Co. NORTH DADE SEPTIC TANK Address 800 NW 111 STREET
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
WORK DESCRIPTION REPLACE DRAINFIELD
phone 754 -3375
Competency# 12842 Ins. Co. MARYLAND CASUALTY
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
Estimated Cost $2400.00
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO
DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated. I certify
that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS,
POOLS, ROOFING, and MECHANICAL work.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work
will be done in compliance with all applicable laws re :• a ing construction and zoning.
Furt sore, I auth1 ize the above -named contractor to do a wo k sta
Owner and /or Condo President
ondo President -
Building
Signat
Date:
4O
No as to C
Notary as -to Owner a
Expire 0 9 4 1 'Y PUBLIC; STATE OF fLORI®A AT,LAxos My Commission
* *AY COMMIEIPON EXPIReeJUHR 19,
BONDED TH$U HUCKLEBERRY ouseC1A' i
APPROVED: Fire
* *
Tax Folio // 3‘21/ o/ 6/%
Master Permit # NA
r Electrical
) `kineering
ONOTARY P S I C / S T A T E girt/ HEA AT LARGE
XP re s : MY COMMISSION EXPIRES ADZ 19. 1995
* BONDED TAU HUCI(LR RRY & ASACIATS
Other
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL ❑ Date 19_G1
PLUMBING ❑ PERMIT N9 9209 Contractor's
ROOFING ❑ License No ^� t 'a
Owner of
Building V: _ = i
❑ Work to be performed under this Permit
Architect
Contractor
or Builder ~' "
Legal Lot
Description 11 Bl.
Address of E T�
Building
CONTRACTOR or BUILD
Subdi-
vision
Sg Ft
Value of I I Amount of -
Project $ I I 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 applica-
tion 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 respon-
sibility for work done by his agents, servants or employees.
11�a -
Signed • (INSPECTOR) BY
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 str• conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I as me r on or all work done by either, myself, my agent, servant or employee.
r f / 11,
BY AUTHORITY