457751 '
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/h/7.49 Job Address 0 '0Z N& Tax Folio
Legal Dron O / . 4/1 ie S historically Designated: Yes
NO
Owner/L ssee /Tenant /i44 '' �J /1 /1 Ze C ! iki( 14 el44 4faster Permit # 1157
Owitc's Address 41 2 e?‘ f Phone k Y ii i -' `75"x-/
Contracting Co. J�Il.4.i4 lT e 57 y /4 G Address 93 NV t`v�•ti Dr.
Q SS# ' / Phone a s'8 o
State # Miimicipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Moigagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION C' I J //VS1g -- /,Z i' A —
Square Ft. 4,0
WARNING TO OWNER ' YOU MUST RECORD ANOTICE 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.
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
d zoning. Furthermore, I authorize the above -named contractor to do the work stated
0 PILES rat 9 c u t Cut
MaMAGE . Mein
owner Date
Signature
Alit
•,uIIii' I
and/or dent
Michnei J. Maxwell : '
) .\ Notary Public, State of Florida :
Conum isaion No. CC 601040
' r.'N My Commission Exp. 0131/2001; '
Bonded Through Fla. Noway Service & Bondinn,Co. ; ' k ° FEES: ,. l »a3h .. is . Wi > »»»>s'
C.C.F. / ' NOTARY '
My
APPROVED:
// /7,9?
Li—
Estimated Cost (value) 5
BOND ..
TOTAL DUE
Date
Zoning
114i. Electrical
Date
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address Tax Folio
Legal lmon
HistolioallY Designated: Yes
Owner/Lessee / Tenant Master Permit #
Owner's Address Phone
Contracting Co. Address
Queer 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
Square Ft. Estimated Cost (value)
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
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.
Signature downer and/or Condo President
Notary as to Owner and/or Condo President
My Commission Expires:
FEES: PERMIT' RADON C.C.F. NOTARY
w ION # CC 724292
EXPIRES: April 18, 2002
144OO4.NOTARY Fla Notary service & Bondd19 Co.
Si
as to Con
My Commissi
BOND
APPROVED: TOTAL DUE
Zoning Building Electrical
Mechanical Plumbing Structural Engineer