33220PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
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Date j d Job Address )0f".
�.. � � .Tax Folio � � ��� ('T l
Owner / Lessee / Tenantt Pl
Owner's. Address _ r j P one ° 0 9 2 3 4 it FP/ (
Contracting Co. `_�' `� v Address . Ij �' 'it 1"1
Qualifier ( � K.=� -SSA - - Phone c4 --- `Z � 7O Q'
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State # G Municipal # Competency # Ins.Co.
tho
Architect /Engineer "
Bonding Company '- Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANI
WORK DESCRIPTION - '�
Square Ft.
ature o
Date: I® /fir
04, `
N rt' h as to Owner and / or Condo Prlesident
Commission Expires:
ta
** *
FEES: PERMIT
APPROVED:
0
1 0
* * * * * *
RADON C.C.F.
Fire
Zoning Building At-rt9ot
Mechanical Pltmbing
Address
ROOFING PAVING FENCE SIGN
Estimated Cost(value) "rz-c0 � rxs a
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING MICE FOR IMPROVEMENTS TO YOUR PROPERTY (F. YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT)
Application is hereby made to obtin 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 MECHANI WORK.
information is accura e and tt all work will
OWNER'S AFFIDAVIT. I certify that the foregoing i
be done in compliance with all applicable laws regulating construction = d zoning. rthermore, I
authorize the above -named contractor to do the work stated.
NE MOM
as to Co
y Commission E �• '.
take an oath or
DID NOT take i oath.
Vz �O NOTARY 5,04 TOTA DUE iy �l�
Other
Electrical
Engineering
**
State of Florida
County of Dade NOTICE OF COMMENCEMENT
THE UNDERSIGNED hereby gives notice that Improvement will be made to certain
Owl! 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) iN1 K C I t »o ÷5 1 10 6O? . N! C i 6 st; "`
t'h � a oft ; 5 1,ore 5
2. General description of improvement: $4. e e J •Q e. D , r 0..
U
0
CO
3. Owner information:
a. Name and Address: M Iq,m t S heo r e f Psec yler-'aet 6 °,L Al ?t' T 3'
i"
b. Interest in property:
c. Name and address of fee simple titleholder (If other than owner):
4. Contractor: (name and address) kt-A + '1 C 0\ n L p3 3 w i6,, ed F0o04 ®c
F ./ r"'yerg,
5. Surety:
a. Name and Address
b. Amount of bond $
6. Lender:(Name and address)
. • :STATE Or FLORIDA
COUNTY. OF DADE
t HEREBY CERTIFY that tits Is a n„
oll ginei f7 s0 Inds Wee
WITNESS my hntd an4
A. D„
Offtcis! seal.
Ole* arsuk
OW* a Was
ere to r• Q d 6y fa v► 1 a t4 a. CVO'
331 SM 1 ?`Q ;
2; pre
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
to receive a copy of the Lienor's Notice as
provided in Section 7.13.13(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 d to is specified) ,
Gec4Pdd
SP;9e1
LS�I gnature of Own r
Sworn to n d subscribed before me this iY day of O i - L t,,,— 1991.
_ ! �� No#Ry Puislica � ,
Rorida
Notary Pub1.1C . May CommtssI on
of