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999 NE 94 St (12)Date Legal scriptionYe Owner / Lessee / Tenant:7� Owner's Address Contracting Co. Qualifier State # Municipal # 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 Square Ft. Estimated Cost(value) 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 / j Signatb6e of owner and /or Gondo President Date: 1 3 4 N , ary /as to Owner an My'Commission Expires ** * APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Zoning Job Address 9 / l c ° 9 V 9 JOSEPHINE CHURCH :Notary Public. State of Ronda A trite FEES: PERMIT376 RADON ss#2J - - ( Phone * * * * * C.C.F. NOTARY 5 DO TOTAL DUE H ,41 Fire Buildin ( 6 -7 Mechanical Plumbing Tax Folio e 3 Master Permit Phone 7 534-5-2 7/ 2 Address _3 S igna Contractor or Owner- Builder Date' S. t. .I, . : 1 _. +a tar /as to C y Commission x MINE CHURCH r:Nbion04 i ► °O;' No CC197515 ** Other Electrical Engineering 1 1 1 it LL Owner's Address Contracting Co. PERMIT APPLICATION FOR MIAMI SHORES V Job Address ?/ 9 /r/ r 7 Tax Folio Date Legal Description Historically Designated: Yes No Owner/Lessee / Tenant l 7 ti( n as 4-b. Address Master Permit # 1-1 /co 7 7JT - Sy , If Qualifier r ,g=lea -4 SS# ( -_ 7 State # Municipal # 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 - I (\ 3 (0 o f cti\d kf k S e Estimated Cost (value) ('1 © 0 Square Ft. Noaryast My Comm 3, 2- 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. 1 ure of owner and/or Owner and/or do resident Date res ent • ijes: OFFICIAL NOTARY SEAL 6' F MCCOY �c +, x COMMISSION NUMBER y r t, l CC542908 F (�� MY COMMISSION EXPIRES � F FtQ ....... _APR. t . 2 ate 1 Ar — s ! l ir a4A 11.1 Z i FEES: PERMIT RADON APPROVED: Zoning Building Mechanical Plumbing C.C.F. S r-s. (4 77s. W • • .1 + . -r of Contractor or 0 to Con ctor o r ires: er- Builder er -Build Q � </ WIY p , OFFICIAL NOTARY SEAL SAMUEL F MCCOY 4( • 7 * COMMISSION NUMBER 'IIY=' Q CC542908 7„ • 4 MY COMMISSION EXPIRES \ APR. t ?,IMO() Date Sign My Co fil\1/fq1 NOTARY Electrical BOND TOTAL DUE Date Engineering