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1099 NE 96 St (8)f MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Estimated Total cost of improvements $___ = i Owner's Name and Address_=_,_.._ " ,' - -'-�' No, , C'' .d //,f.,/,- Street- - --,-- Registered Architect and /or Engineer_______ Name and address of licensed contractor Location and legal description of lot to be built on: Lot__ Block_ Subdivision Street and Number where work is to be done , State work to be done and purpose of building (by floors). Ls! Date • s, 10 g7 y� and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of ( " Kind of foundation./ ___._ Roi ug i� Amount of Permit $ d Zone cubage required �- _Plan Cubage Distance to next nearest building 2 ( - ,f _._. Size of Building-Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to — _ -� _ – •�__ -. , __ _.__�_ "_�__ _ • mL , ' E %> 0 d i 19 l The undersigned pplicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the F orida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks__ (Signed • -- _ - __ -.� . _ _ -- -- 1 STATE OF FLORIDA, COUNTY OF DADE. Ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. / '7 Date a Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector to me well known, Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. R.F.Bierbawn PAID BY 8 •14-51 YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT 1 ADDRESS 1099 N.E.96th Street LEGAL 1&2 Sec #3 RECORD GARBAGE TAX BUILDING ELECTRICAL PLUMBING ROOF) NG Owner of Building PERMIT IT? 11907 n Work to be performed under this Permit Architect Contractor or Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE, FLORIDA Subdi- vision CONTRACTOR OR BUILDER BY Value of Project $ DATE 195 Contractor's License No it $ or device described in the application 1 .erformed in compliance with any plans, tho es. This Permit may be revoked at any further condition upon which this permit is This permit is granted to the contractor or builder named above to construct the building or to install herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the wo drawings, statements or specifications that may have been submitted to and approved by the proper municipal time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. AUTHORITY INSPECTIOIaS DATE I BY RE- INSPECT BY RE- INSPECT BY FOUNDATION ('• 1 FEE TEMPORARY SERVICE e"."''' '. _, $ BEAMS & LINTELS SEPTIC TANK taZ . ,/S` - �.f5 •:1`t • $7 � ^-- ..- SEWER G FRAMING • $ SOLAR HEATER $ $ GAS .1 $ $ A':,.e $ INSPECTIONS FINAL /- /7 -5a pi,e B RE- INSPECT BY RE- INSPECT CLEAN -UP I p C - 5 - 2 ,> 9 ea CONTRACTOR dk VO- PHONE PERMIT NO. HQ If DATE S' ,a/' J _ FEE $ / / / NEW BLDG. I ALTERATION 1 ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE e"."''' '. _, $ $ SEPTIC TANK taZ . ,/S` - �.f5 •:1`t • $7 � ^-- ..- SEWER G S $ SOLAR HEATER $ $ GAS $ $ $ INSPECTIONS INSPECTIONS DATE B RE- INSPECT BY RE- INSPECT BY ROUGHING 9 ea ROUGHING GAS — H. W. HEATER CONN SEWER RANGE CONN. SEPTIC TANK f'-: , ..» - SOLAR HEATER FIXTURES & FINAL FIXTURES / / / �7 SZ' CONTRACTOR =, - P PHONE PERMIT NO. DATE / ^ ' - - FEE $ NEW BLDG. 1 ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE LI T .- � e"."''' '. _, $ H. W. HEATER CONN. ✓ $ RANGE CONN. S MOTORS $ FIXTURES V $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING /b 3 k ". ' ! n — H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL / ^17,:7 ,1)b/ I <$ ULL.Dt NG INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE / _ / '7 _ S 1r_ OWNER'S NAME R.F.Bierbaim PRESENT ADDRESS 54 N.W•95th Street LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) 1099 N.E.96th Street LOT 1:2 BLOCK 2,A SUBDIVISION Section #3 - GENERAL CONTRACTOR John P!I.Ritter & Bon ADDRESS PHONE NO. • LICENSE NO. BUILDING PERMIT NO. 11907 1����j DATE -1 45 1 i PERMIT FEE 51 24.00 BUILDER'S BOND NO. DATE q5,000 ZONE REQUIREMENTS CU. FT. 35,3 PLAN CUBE CU. FT. $20000 EST. COST $ D•Hansell DRAWINGS, SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: DATE 8-2-51 NEW CONSTRUCTION n�TlYPE COST STORIES ROOF CONSTRUCTION the Ten......„ � INOTE a R n fla oors -"ter F,a ! $�� 1 a - '_'_ ceilings REPAIRS DESCRIPTION ALTERATION DESCRIPTION ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. D ISSU ° , " ��� J, BY ��%,� TO � '',/1Y+ i , BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE N9 1487 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Owner, Agent or Tenant of Building Street Address 1 tf mo Miami Shores Village, Fla , I "" Lot 1' is Block Subdivision t ` Approved use by occupancy Remarks- This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known ss the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. BUILDING DIVISION F IAM SHORES VILLAGE, FLA. No JOB Z' Eel , 40, Ti; ADDRESS /1 ' c't INSPECTION (�� TIME READY 44-1 REMARKS: 1 _ INSPECTOR DATE 2444 N° 1487 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Owner, Agent or Tenant of Building Miami Shores Village, Fla., 1 - / 43 Lot i ∎ a Block Subdivision .. 3 Street Address 1 0 e Approved use by occupancy Remarks. This Certificate of Occupancy is issued to the above named 61,4-1r, for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. 1 s` 14-CA BUILDING DIVISION MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date Jan. I6,__ , 19 73 Owner's Name and Address Joseph Weiss No 1099 Street __.N.E. 96th Street Registered Architect and /or Engineer Joaquin Vazquez Name and address of licensed contractor Jack August 5115 E. 10th Avenue, Hialeah, Fla. 33013 Location and legal description of lot to be built on: Lot__ 1 & 2 & 3 Block 82 Subdivision Miami Shores Sec.3 /PB1037 Street and Number where work is to be done 1099 N.E. 96th Street State work to be done and purpose of building (by floors) swimming pool and for no other purpose. New Building X Remodeling Addition Repairs No. of Stories To be constructed oLORI i to Kind of foundation Roof Covering Estimated Total cost of improvements $ 3000 Amount of Permit $ 0 Zone cubage required • Flan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor___ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to_ _____ ._ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida, Pennanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such su contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. `^ ( /` Remarks — (Signed) �� ti "C.. t4` / Date Disapproved Notary Public, State of Florida PLA NING BOARD ___ _ __ DATE Chairman / _ _ Member Member __ _ Member Member . Member Council Approved STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and•who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No I C / S Date ___. - __ L : _1 -- 7� _ Read, Sworn to and Subscribed before me. Disapprove___ \- _ Date (Signed) - Bui . ng Inspector / y-- Commission Expires Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 0 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address___JQ.58Pb1_-_Wei SS No._ Street_-N..E..___96tb.Street Registered Architect and /or Engineer Joaquin Vazquez Name and address of licensed contractor Jack _.. August __- 113__E.____i 0th __Avenue.,._ Mialeah.,___Fla .. -__ ._33013 Location and legal description of lot to be built on: Lot i& 2& 3 Block 82 Subdivision. _ tI_ !mI____Sh ores___Seca3LPB1037 Street and Number where work is to be done 1099 N.E. 96tL__ -Ste t State work to be done and purpose of building (by floors) swimming pool Date - Jan I$ - - >1973... and for no other purpose. New Building X Remodeling Addition Repairs No. of Stories To be constructed of Gun 1 to Kind of foundation Roof Covering Estimated Total cost of improvements $ 3000.00 Amount of Permit $ Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor___. I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks -- - - - - - -- - (Signed) STATE OF FLORIDA, 1 COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared - -- - - - - -- - - to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Date Read, Sworn to and Subscribed before me. Disapproved ____ _ Date_ (Signed) Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD__ __ - DATE Chairman _ _ Member Member Member Member - ___.__.__._ ._ Member Council Approved ___Date Disapproved NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build - ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Street and Number where work is to be done STATE OF FLORIDA, COUNTY OF DADE. j ss Disapproved Date.. (Signed) APPLICATION FOR BUILDING PERMIT Registered Architect and /or Engineer Name and address of licensed contractor .... Location and legal description of lot to be built on: Lot Block Subdivisio / .9 State work to be done and purpose of building (by floors) (it l 6 9'Ld - Building Inspector New Bui!ding Remodeling v Addition To be constructed of Kind of foundation Estimated Total cost of improvements $ Amount of Permit $. Zone cubage required _.._...plan Cubage Distance to next nearest building. Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen s Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such tractors, on work t9 a performed under this pennit, as are licensed by Miami Shores Village. Remarks ( Signed) _.. ; Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him sta d are true. (� c 'Permit No. Date "Read, Sworn to and Subscribed before me. Chairman . Member Member _..._....._.__.�.__._ Council Approved Date NOTE: A charge of $1.00 will be made for the Planning Board. A re inspection fee of 31.00 will be charged materials and/or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT. ,19�S.o ,..G ��' ...._. No. /a 9 2'. Street.2 PLANNING BOARD DATE and for no other purpose. Repairs No. of Stories Roof Covering Notary Public, State of Florida My Commission Expires to me well known, Member Member Member .... Disapproved Date making corrections or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection or faulty tc' 6 T2, 6 AA. `rj / MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date... ..._. _l! ...__ .. t . ,19.2 Owner's Name and Address i (c1 �- • --- No.. L � 1 –• Street » Registered Architect and /or Engineer Name and address of licensed contactor L .� Location and legal description of lot to be built t on: Lot....... -.2- '�! Block -2-- Street and Number where work is to be done State work to be done and purpose of buil ing - floors) Subdivision. — =- 5 -1 2_ 3 and for no other purpose. New Building Remodeling ddition {...r Repairs No. of Stories To be constructed of Kind ofoundation . – ����– � _ Estimated Total cost of improvements $ —C) Zone cubage required Distance to next nearest building Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the - Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for jnspeetion on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such/stibcontra rs, on work to be - performed under this pennit, as are licensed by Miami Shores Village. Remarks (Signed STATE OF FLORIDA, 1 COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authoriz administer oaths and take acknowledgments, personally ap- peared .Plan Cubage Size of Building Lot 1 ( 3 _' and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the eregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. -__.___. 7 - 7 C Date � � -- Sworn to and Subscribed before me. Disapproved (Signed) .. -. Buildin Inspector Chairman Member Roof Covering Amount of Permit $. _Notary Public, State of Florida PL INC BOARD DATE Member Member My Commission Expires to me well known, Member Member -- - -• - -- Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 31.00 will be charged when such re- inspection is mado necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING' ROOFING rchrtect•' � .. ,.. Contractor'.� # ! OWNEP , or Builder : 1 . , 4•.'. A Description Address of � Buildin 1099 N. ; E. ° 96th ST. 4 This permit is 'granted to the contractor or builder named above'ttii consirucf'the` building or to install the equipment or device described in the applica- t herefor in. strict compliance with all ordinances pertaining thereto and with the. understanding that the work will be performed in compliance with any : plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is :not done in compliance with such ordinances or if tbe',plans are changed without authorization. A further condition upon which this : permit is granted Is the understanding that the contractor'or builder named above ,assumes • the responsibility for a thorough knowledge of the ordinances and s regulations pertaining to the work covered hereby whether shown on the w . plo or drawing's or in the statements or specifications and that he assumes respon- sibility for work done by his agents, ser s e 1 • yees. 1, } + r ' ., k ,,A.,-, , ,. - r n 4 t A"ii f(t lr -. { . i a t a i Yp ' ��- } �1 P * � Signed a t ''l, + t i (INSPECTOR,` �,' BY • In copetderation of the' issuance to me of this permit' I a gree to,.perform the,work'coveied hereunder in compliance - with. all ordinances and regulations .,, Accepting: this permit I assume,. responsibility for all . WorkAone by,. 'idler"' myself • mY t em .. p .Tertaining thereto and in.strict conforinity with the plans, draWings, statementa or.ipecifkations submitted to the proper . authorities of Miami Shores Village..., t MIAMI SHORES VILLAGE, FLORIDA . Date9/ 3/ 85 Work be performed under this Permit EXTEND POOL PATIO —CLOSE FIVE • • CONTRACTOR or BUILDER WINDOWS ON 1? th AVP. s E 1 3206 14 3650 0 Subdi MIAMI SHORES SEC 3 vision Sq. Ft.. Val of . I ' Amount of Proue ject. $6 , 000.00. Permit $ 150.00 Contractor's License No. :AUTHORITY Date 7-8-F Z Job Address l o g t tit U. sT Legal Description Owner / Lessee / Tenant Contracting Co. 7.2)i) C.- Permit Type(circle one): WORK DESCRIPTION Si natur f owner and /or Condo Date: 7/ g); 4,x,t�,, a --ad My Commission Expires: APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE CST /,' 2- /gee P� A f, Sec.3 s l wee 3 Owner's Address "1 V q 9 r /hN4� s�.... i Tax Folio // '& J J4 V7 Master Permit # 3 Phone 1r7 ! d rc een vTit ✓ e.7 7 ^ Address Z 4 . s 6'41 ,S0-*-- �-✓t Qualifier O14%/I O 4Rt %+f4. SS# phone 0019 ys 7• 3 S 5e1- State #C64.037801 Municipal # Competency # Ins .Co. 6 "A"' • A , i tep. Architect /Engineer Address Bonding Company Address Mortgagor Address ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Flop& 1 % t 7 c_ P 1 1 w 0 e..Q b A.� d .•1 President Notary as to Owner and/or Condo President E �•�• -• �+v,. Otis. Lin). ** * * * * * * * Mechanical Plumbing Square Ft. 70 -1 Estimated Cost(value) I vir4:9 O ..o 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. * * Signatur o Contractor or Owner- Builder Date: 7 f 5 Notary as t Contractor My Commission Expires: * * Engineering or Owner- Builder ..... *.......�. *. .. ** FEES: PERMIT r /Y " RADON C.C.F. ) NOTARY TOTAL DUE G' Fire Other Zoning Building 7h), lt-. Electrical