MECHANICALDate/ Job
Legal Description
Owner's Address
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Address / /D77 /V ,6 S Tax Folio // £ 91 /4 , 5 0 0 , e3
/ Lessee / Tenant ti m'y' .4((e/ .9•4/,5Ot)it/�
77 ,/6 9 5 cr
Qualifier 4277o v` / ?-vWzZ
State # C/C1Ca6sy8 Municipal # 77 Competency #
Architect/Engineer
Bonding Company
Master Permit #35
Phone 75 7 - o05v°
Contracting Co. U /�O n�I`t/'/9a/ Z '9/C' /ec''c/e /6c "2 Address /m Grp �° 67. 1704, fit. - 330/ 2
Phon j3o�)5.5 7 - /521
Ins.Co.
- t.pio4fr `
Address
Y Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBINQ(MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION € of -.-t-'4577'1)6' -9/C 4 7- kJ/ W 77/./42(k)
3.5 7'3 /9/c (A)/75 77.eiv(2) ,9/2 avr 73.
4 (a) /o fr14,) / ,
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.
Signat a of owner and /or Condo President
Date: Date:
Address
Signature of Contra g " or Owner- Builder
Notary as to Owner and /or Condo President Notary as to Contractor or Owner- Builder
My Commission Expires: My Commission Expires:
** * * * * * * * * * * * * * * * h **
FEES: PERMIT i "'1 :! ,5d RADON C.C.F. 1 } t NOTARY TOTAL DUE' '
APPROVED: Fire Other
Zoning Building Electrical
Mechanical ►\/ 1 1)f/T , Plumbing Engineering
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
Date 1/-27- 93 Job Address /t777 WE 9 5 +e'p* Tax Folio
Legal Description
Owner 7/071(74/ ,qdD 4ke, A,4( c .) c✓.)r
Owner's Address /677 .116- 9 ' 7 '
Contracting Co. a770 ''11'Q''" / / C J Address
�
s
Qualifier t ;7Z I. ,eA.101 '
State#
C�`/ CO 65 'l8 7
Architect /Engineer
Bonding Company
Mortgagor
Square Ft.
Signa
re of Property
FEE
Owner
Competency #
or Condo Pres.
ADMINISTERED OATH ❑
SWORN TO & SUBSCRIBED BEFORE ME THIS
07 T OF NOVE , 19 93..
Signature of NOTARY to Owner /Condo President
NOTARY PUBLIC, STATE OF FLORIDA.
MY COMMISSION EXPIRES: August 19, 1995.
BONDED THRU NOTARY PUBLIC UNDERWRITERS.
(Print, Type, or Stamp Commissioned Name)
Personally Known ❑ or Produced I.D.'
Type of I.D. produced p4QtVEdeS jdt /V.S
Zoning Building
Mechanical Plumbing
Tenant
Master Permit #
Day -Time Phone 75 7 - Q056
/0 ‘6 sr• t /i6. 'e)/2.
( ) J S 7-/3Z3
Address
Address
Address
Permit Type: ROOFING BUILDING ELECTRICAL PLUMBING (MECHANICAL) PAVING FENCE SIGN
Application is hereby made for a permit to do work & installation as indicated. I understand that
separate permits are required for Electrical, Plumbing, Signs, Pools, Roofing, & Mechanical work.
WORK DESCRIPTION R zroccL/EAr 6/ X / , U& 4,0/ o (z)
3.6 7 - ,t) /7't 7 &06 t/,i)/ 01,),,i)14/z20/7704) Dp quo //2 d!/ft Z
Estimated Cost g 44141
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 THE NOTICE. A BACKFLOW PREVENTION DEVICE
PERMIT AND CERTIFICATION TEST MAY BE REQUIRED IN ACCORDANCE WITH ORDINANCE #825. CALL THE PUBLIC
WORKS DEPT. AT 787 -1001 OR VISIT THEIR OFFICE AT 1815 N.E. 150 ST.
°PRIER'S AFFIDAVIT: I certify that aII the foregoing Information Is accurate, and that aII work will be done In comp Ilan with ail
app II cab le laws regulating construction and zoning. Furthermore, I authorize the above -named c ntractor to do the work stated.
Signature of Contra or
ADMINISTERED OATH ❑
SWORN TO & SUBSCRIBED BEFORE ME THIS
27" H DAY OF NOdZ/ 6Ud , 19 95 .
1 ns . C o ..S ®i✓ e6 - /704
Signature of NOTARY fo Coniractor
NOTARY PUBLIC, STATE OF FLORIDA,
MY COMMISSION EXPIRES: August 19, 1995.
BONDED THRU NOTARY PUBLIC UNDERWRITERS,
(Print, Type, or Stamp Commissioned Name)
Personally Known )4 or Produced I.D. ❑
Type of I.D. produced
Electrical
Engineering