278 NE 97 St (3)Date
Type Insp'n
Permit No.
Correction
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Phone # l b. . A
For Inspector? 1 6
Approved i
o
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTME ~�
305- 795 -2204
Date
Type Insp'n
Building Inspection Request
Permit No. L (r)3-33
Name
Address r D\lY f)T c• i-
Company'7
Phone #
Inspection Date
Approved
Correction ❑
Re- Insp'n Fee ❑
Date
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
g3
. P e . J o b A d d r e s s .7 7 Tax Folio // -j be 0 : 6/3 3 '7e›
Legal Descriptiort # 4' y. ,&
Historically Designated: Yes No v4
Owner/Lessee / Tenan#75 )V 17 /0�� Master Permit # a 3 03
Owner's Address o.78 ovE f2
Contracting Co.,,J7?l.,1�S 6 //c- e re0e r ,
Qualifier ..lO *eS
State 0e, ag 2 3 g Municipal # 7/ y
Architect/Engineer
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION le \Zea /147 ��.o t 4- adze.
7„7,;/6 ie.,/ 4,4
Square Ft. /-r, Estimated Cost (value) Zi�f °
�a` 9/ 5 / 9( ,
Signature of owner and/or Condo President Date
(
Notary as to Owner Id/or Condo President a t
My Commission E •
FEES: PERMIT
CRESENT MARROW
State of Florida
My Corn. Exp. Jtate 29,
Comm. # CC 547942
RADON
Building
Phone ‘..577 _ ;4,7
Competency # Ins. Co.
Address
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.
C.C.F. /- NOTARY
Phone 7.5 7 — 4/3 S
��.e
ature of Contractor or Owner- Builder
Notary as to Contractor or
My Commission Expires:
Electrical
47k
CRESENT MARRIOTT
State of Florida
wly feann Jtne 28, 20�
3e ()
TOTAL DUE ai
Date
Date
APPROVED:
Zoning
Mechanical Plumbing Engineering