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780 NE 94 St (9)Date Legal Description o ' '7 9 //A i9SrP/5/'9 ( T APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 780 "VG , . a Tax FolioJJ,30 0 /'7 / DJ Owner / Lessee / Tenant n 7 Owner's Address 73 © ,/Irr 74" aT /0"9• d rd,rS Contracting Co. c.5//�' '2,5 Address erc.} OO .57 Qualifier ,,7',S �i,-1-7 5 SS# Phone g�CU cS 7 2 ` State # Municipal # ,e --- 2 0 0 4/ Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 6Vs'a V 4FA4J77 Z2,24'4= Yv /Th , /AP?" Square Ft. /3670 Estimated Cost(value) 9 4.S 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. Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President ''tar as to CciktraWADVILI eg "'eu My Commission Expires: y Commission Lei¢ i e :"`nbcr :Li. gLy 0 DID rake an oath, or ,Y ** * * * * * * * * * * ID l�i0 take a *oath * ** FEES: PERMITJ1.579 RADON C.C.F. ,, j ® NOTARY ___4 _..7 G ®/v TOTAL DUE 4/3 Fire Other Zoning Building 5F- /8- 5 Electrical Mechanical Plumbing Engineering Master Permit # 1 Phone �- F 3 3 2 .....,-.;.:::'..:''.:...... f:,': .... ' ". MEE T: PLANS :.:,E - ;':• .).:1. 0 WITH ::o •••: - . '-' • NO OTHER •-*". ..... • .. : - 3RD !; •.• ; • - -'.• - ,;; • - Ali_ 01'.F.:? ,..:•;'' • ''.- :•.ITH :3•( AI ..1 . .e.. •.:: r;- -. ::. : PERMIT I. : °. r : ' . :"-:' :-: "PFrIARKS" : - • • • ••••• : :': • .i) ZOIfiG • ...'• ..-! : 7 . • -7 . ' 1 5 . :IoW , .- ..i • ",'. 7. 1 . ' ::. 1 ii!E ;:jiRLIED • •:-• : 4 ' S grilture Dlte 1;E Ni'; . . , ._ii; WORKS .. POLICE DEPARTRIEU BUILDrIn. I:RECTOR PLANNING & ZNING . i".... : VILLAGE COUNCIL APPROVAL PRELIMINARY: FINAL! REMARKS: COMPLIANCE WITH THE SOUTH FLORID... 36I'D: .3 C;0;F_ ;•-.S AD•: BY MIAMI SHORES VILLAGE IS REQU KO. T. E ARCIIIET. DUi DER 9 , SUB CONTRACTORS ARF ''.• f: -.-. ' • :' 'I- ! -- ^r • .- • - .: ). ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN.