294 NE 97 St (3)PERMIT APPLICATION FOR MIAMI SHORES VILLA
Date Li (L/cp Job Address ?C k-4 t E i 1 �� Tax Folio
Square Ft.
Signature of owner and/or Condo President Date
FEES: PERMIT
RADON C.C.F.
PO -109
Estimated Cost (value) 3 q
Legal Description ice Historically Design l
,
Owner/Lessee / Tenant I l A C D L L GGNA CLP fL
Owner's Address
Contracting Co. 6) -/,v. - Address
Qualifier SS#
State # Municipal # Competency # _
Architect/Engineer Address
C [01 ifs'
lure of Con t or/ Ow 76 r ui der ,g �
C_ /-7 ��6 a
NOTARY BOND
PH -29 A
(/--
Date
.aele 1
Notary as to Owner and/or Condo President ., Notary : o Contractor or Owner 'gilder - - -- Date
My Commission Expaes: My Commission Ex es: i � � G� �
WV gow zp, t ?. mi [?. f gtt32J
APPROVED: TOTAL DUE
Zoning Building /4 Electrical
Mechanical Plumbing Structural Engineer
Bonding Company Address
Mortgagor Address
Permit Type (circle one): MIMING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Pfsch"fr � � Jtl \' EkIJ, u 5 1t1G -,
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 LENDE
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
v
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.
OWNERS 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.