320 NE 96 St (8)PERMIT APPLICATION FOR MIAMI SHORES
Date 6" " f J Job Address 32o ,.✓C 9�
' 51 Tax Folio
TWT cw9l79
Legal Description Historically Designated: Yes _ Pueblo
Owner/Lessee / Tenant
Owner's Address Phone
Contracting Co. Sec--r A 4- � (. b
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ?4' iv• ✓ � c rG sir- 1 S ( 1-✓'.jv1 •
Square Ft. 3°00
?c/o 6c-110 eta,
Notary as to Owner and/or Condo President
My Comnfis
, CI SEAL
<i SANDRA M MONTIEL
* COMMISSION NUMBER
CC401261
t c§ MY COMMISSION .EXP.
O F` n AUG. 17 1998
FEES: PERMIT g-7 - RADON
Date
Address
Master Permit #
Estimated Cost (value) 4" / 70 C�
M3
f Contra or or Owner- Builder
Cor�i`i 4.QJ Bg L NOTARY SEAL
ei SANDRA M MONTIEL
2 w , * COMMISSION NUMBER
N 4:Ir.. Q CC401261
9 j '•w Q� MY COMMISSION EXP.
F OF F\.O AUG. 17 1998
3 71 .S -- D
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 ab e-named contractor to do s e work stated.
Date
Not as to p races r n
n a smor �••:: ^ ^
a
Date
C.C.F. _ NOTARY TOTAL DUE J
APPROVED:
Zonin g Building 5 Electrical
Mechanical Plumbing Engineering