45 NE 96 St (6)WORK DESCRIPTION -es s
Square Ft. Estimated Cost (value) DA-7
1 .`` ..� 0AL `-1� ' Y
Signa ! a ppf 9 vner . i d/or Coop '
:1 / I I ft 1/
tary as to ti , an•for Condo President Date
y Conunission Expires: _._ �____�
OFFICIAL' NOTARY SEAL
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FEES: PERMIT `7 RADON
APPROVED:
Zoning Building
Mechanical
Address
resident Date 96 Signatur
sya,rQ s K sr
C.C.F. & D NOTARY � BOND
Electrical
PERMIT APPLICATION FOR MIAMI SHORES VILL
Date l a " Job Address It St- (^ � 6 it 9j Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant 0 i�90,.� A /So u C --2 Master Permit #
Owner's Address Lis (J E ! C 1't- �' 4 w -e.-e—+ Phone S
Contracting Co. �. S b v- <= P -a. Address C a g /� ° ' A Si -
Qualifier l cti S 1r, . � ,r \ SS# Phone '3c ) 7 Ff .S ^ (cos
State # Municipal # Competency #00•30 i $g 4( Ins. Co.
Architect/Engineer Address
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
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1/A 345
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If . LA—.--.I .41..1,---"— er uilder Date
a . - .6 1
otary as to Co G ,'� 0 '• P LL. ° : LC FDA , Date
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
la ws = tin. .• • , ction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Plumbing Engineering