935 NE 95 St (13)Date
Legal Description /IZ ��N.ts / i 4 Historically Designated: Yes
Owner/Lessee / Tenant /7 V T,9. /'Oz—z..).•
Owner's Address 3$ /Via"
Contracting Co. 11 CORP
Qualifier 339F'' V
State # Municipal # ,264: d Competency # 4 X04 0 Ins. Co. S Z2 0
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN FENCE SIGN
WORK DESCRIPTION / +. Eft's ; ' C
l /��/zo Fir / ' 7 7 c f '9'07 ,, z, 19.1'
Square Ft. P9 fp
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 do the work stated.
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PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 7 3 w� 9 . T Tax Folio
DELORES INGRAM
MY COMMISSION CC 834783
EXPIRES: April 24, 2001
%Rf,h Bonded Thru Notary Public Underwriters
FEES: PERMIT l ib. RADON
Signature of owner and/or Condo Preside t Date
P`101) 4 0_77O- U
yi/L
Notary as to Owner and/or Condo Pryb ident Date
My Commission Expires:
APPROVED: Zoning Building W 41; /L7CY
Master Permit #
Phone 73Y ° - 3 4 /76'
wr ►A'
Address Ad 3 0 .& ��i�ver J3e5' )9
�rC
SS # Phone „3d> - 6 2 a -5 7 7
3479 ,42DG ,a /21 VC7 L Sf'�L 6- w Cir £.'4!O
Estimated Cost (value)
S
of Contractor or Owner- Builder Date
Notary as to Contractor or Owner- Builder
gj Expires:
* * M y Commission CC738906
,. —1
Expires May 3, 2002
C.C.F. /. NOTARY TOTAL DUE 9 b a /
Electrical
No
4 / 1 0- OCc,
%% Date
-3
Mechanical Plumbing Engineering
•
Sur
Mi at
LL DESCRIFTIN Furvbei Ly Ci:i
LEGAL DESCRIPTION: LCIP 2) and 21
OF MIAMI SHORES SECTION NO.
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