Loading...
DRIVEWAYPERMIT APPLICATION FOR MIAMI SHORES VILLAGE ' Date 3 ' ( -7 d Job Address Ogg A4 17 t Tax Folio ic Legal Description /7 Historically Designated: Yes vNa0� No / Tenant Owner's Address Contracting Co. 9 Qualifier State # /P ALA- SS# Phone ff,(le, Municipal # C Competency # Ins. Co. Architect/Engineer Address Bonding Company SJ / 4 Address Mortgagor Address Permit Type (circle one): c1 UILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIP'T'ION - ` � °�►�"T Co' - C ET E Si Square Ft. 45 ? 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 constructior'nd zoning. Furthermore, I authorize the above -named contractor to do Jhe work stat a e of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: 2 a0 FEES: PERMIT Ile. RADON C.C.F. / NOTARY BOND aC�, APPROVED: i r r Zoning Building l Electrical Mechanical Plumbing Engineering S In Address Master Permit # Phone Notary as to Contractor or_O -Build My'Cori issiq� Fsicpir ,a C, ©4ls -V c �, pama,a cox,, :oa n s f Contractor or Owner Builder Date Date / � ■C? TOTAL DUE " k•'• /3.9o - iz to: 0 27, go' ao • is'nzzey i45l fio /, 00, oo .35.00• a .36, ego • Y1 • Sri «�' C174, / Z5.85- ZO.3 N /9 90 3 79 1 . 1%:9o, G� 3 7 .. a // S C .7c . S4.0 e/ 3 Pp��w ()r) vcvl • �rwe/J�✓ - 977 ,71 - cc � �' l 2D X7s0A0 / / ve