740 NE 94 St (10)Legal Description //// Historically Designated: Yes Isto
Ovin / Tenant / 4 7 4 7 cy Le Master Permit # 9
f Owner's Address Y1OA.09r -Vt .5 Phone S 7-s - 7
Contracting Co. !,v,4/e. Address
t
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION g
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 7V e, ac94/ S? ff. Tax Folio
A,/ /1/24
Square Ft 3 . e ac/ / (1/70
Address
6.; - ���; �� l� , T� au-7 A/
Estimated Cost (value) 6 7 (9 e )
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOU!'
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY OF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDFR
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.
Signature of owner and/or Condo President Date Signature tractor or 1 er Builder
OFFICIAL NOTARY SEAL /
G LADYS J VILLAR - {o - / 0 - f
t/ Date
Notary as to Owner and/or Condo President Date as to Con "re' . e' r;.;l . i OF IDA
My Commission Expires: My Commission MISSION EXP. MAR. t 2002
FEES: PERMIT V° RADON 11 00 C.C.F. 0 NOTARY BOND
0
APPROVED: TOTAL DUE 9 iP
W ii Zoning Building �Au J
Electrical
Mechanical Plumbing Structural Engineer