577 NE 96 St (9)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date( . 1 ( ' ff Job Address . t � 7 e / t I Tax Folio // JQ // r�
/51i Legal scripti.on f c / 1 ,, U1 714,52 4( flip Master Permit # J/1a c1
Owner ,et 3L see / Tenant C4i . FitsiA/1l
•
Owner': :iress 57 7 AL 6 ,7, -�-7-- Phone 758'.9(043
Contracting Co.
Date: -
Qualifier c�is(/.v }%'
State#
Architect/Eng ineer 1 :13 /A/V
Bonding Company
Mortgagor
Permit Type (circle one): UILDING ELECTRICAL PLUMBING MECHANICAL tiVIN FENC SIGN
WORK DESCRIPTION (.4 l h dam`/ exis J Cl2cw)////74 1z CG �Yiy6.ni pa)/i9f,
7 f a/ ,-/ ct j (�e€) 3 0 -oo
Square Ft. 7 0 Estimated Cost
WARNING TO OWNER: YOU MUST 0 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.
Signature, oi Owner aadigoz=ezructoszpdlynt Signature of Contractor or Owner - Builder
lOs;diP
5o 11
/ / a. o
Competency #
Address
SS # Phone 66)?•0
Address
Address
Address
Date:
Ins. Co.
tary s to 0 Owner No and/or Co do President Notary as to Contractor or Owner - Builder
My Commission Expires:604'f' My Commission Expires:
* . * . * * * * * * * * * * * *
PERMIT FEE: APPROVED: Fire Othe
Zoning Building � r Electrical
Mechanical Plumbing Engineering
STATE IF FLORIDA
COUP OF DADE
I HER ; Y CERTIFY that this is a t � opy of the
orlgln+l 'e�.'I in this office on r y 08
,'I7 P , A.D. 19
WITNE * , hand and Official Seal.
.PERMIT # 3/3a e
State of Florida
County of Dade
Cterk Crcuit Cou ..... ,._
•
By B�
3. Owner information:
a. Name and. Address:
Tax Folio No. // -1ac /7
NOTICE OF COMMENCEMENT
9 1R2046 17 1991 JUN 17 14:29
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following
information is provided in this Notice of Commencement.
1 . Description of property: (legal description of the property, and street address if
available) L7' r/9 2f Znlc. , 844c ' �I9 60Boiv': 14 Sex. 4 AMD
�o # !� • 37-126. • /7. /5$0.
2. General description of improvement: 44.72#14g5 47 .LX 7h CkV /i')1i'✓ii
7,e2c&, G , 7 qa p&vMq, tre46i, dr 4 w q
b. Interest in property:
c. Name and address of fee simple titleholder(if other than owner):
4. Contractor: (name and address)
5. Surety:
a. Name and Address
b. Amount of bond
6. Lender: (name and address)
7. Persons with the State of Florida designated by Owner upon . whom notices or
other documents may be served as provided by Section 713.13(1)(a)7., Florida
Statutes: (name and address)
8. In addition to himself, Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),
Florida Statutes.
9. Expiration date of notice of commencement (the expiration date is 1 year from
the date of recording unless a different date is specified)
Sworn to and subscribed before me this
�f ,,>f_ ..:, e r
Notary Pu'o 1 “'E•
Ae'
s ignature of Owner
day of ("24-e-71--e , 1991.
Notary n 'i S , a, p''
My Ccrranit :s. ;lzrsrcas a'
gondcd thruu FAayr :1 ; "
My Commission Expires: