800 NE 97 St (11)Owner of
Building 1
❑
Architect
Contractor 1
or Builder ` 1 r-+
Legal Lot
Description 1 1 BI
Address of .
Building t
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑
ELECTRICAL ❑
PLUMBING ❑ PERMIT N9 9590
ROOFING ❑
Work to be performed under this Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
CONTRACTOR or BUILDER
!r
to
Contractor's , ; , •-I 1
License No.
Subdi-
v ision
Sq Ft
Value of , . I Amount of
Project $ I I Permit $
Date 1 19_4
. •
Signed • 1 (INSPECTOR) BY
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulation
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date � J I/ Job Address /TYO /IC 97 ,K D i�LC� . Tax Folio %J
,(f//
Legal Description /q �/9 ��. /741 ZJ 4 �'y, M aster Permit # ,YX6,/
WORK DESCRIPTION
Square Ft.
Xi) W/Z.4.1 dal
PERMIT FEE:
APPROVED:
Zoning
Mechanical
rvAa
Fire
Building
Plumbing
Owner / Lessee / Tenant C/ hf ,9 - it17) /O/ 4
Owner's Address � /77E /7 g9 /
Contracting Co. aejyye ,W
Address
Qualifier SS# - - Phone
State# Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING
Phone (50EJ 757-
Estimated Cost /5 /. ®
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 above -named contractor to do the work stated.
Signature of Owner and /or Condo President Signature of Contractor or Owner - Builder
Date:
n
{�/' � 11,4 �/✓� - ' .1 iJ4 ,
No ary s to Owner and /or Condo President Notary as to Contractor or Owner - Builder
My Commission Expires: My Commission Expires:
* * * * * * * * * * * yr ,
Date:
Electrical
Engineering
SIGN
-: THREE
BOAR
t f ,
=. ALL NAILS TO < :BE ' GALVANIZ
0'T !NCLUOED.: A,S .• ST AND
ST,4 NEJ AS ALTERNATE.
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