828 NE 97 St (16)BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal Lot
Description
Address cf
Building
PERMIT N° 9340
Work to be performed under this Permit
Owner of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Bl.
Subdi-
vision
Value of
Project $
DATE 195
Contractor's
License No
Amt. of
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 application
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 responsibility for work
done by his agents, servants or employees. f
I s
Signed • BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
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
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Descriptio:z
Address of
Building
PERMIT N° 9380
Work/ be performed under tits Permit
l
MIAMI SHORES VILLAGE, FLORIDA
DATE
Contractor's
License No.
Amt. of
Permit $
d
195
This permit is granted to the contractor or builder name. above to construc the building or tb install the equipment or device described in the p Iron
herefor in strict compliance with all ordinances pertaining th to and with the derstanding that the work will be performed in compliance with any p alle
drawings, statements or specifications that may have been su• fitted to and appro d by the proper municipal authorities. This Permit may be revoked at any 'r...
time if the work is not done in compliance with such ordinances or if the plans ar Changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes pfre responsibility for a. thorou h knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or i oily nd that he assumes responsibility for work
done by his agents, servants or employees.
CONTRACTOR OR BUILDER
Signed:
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance
pertaining t rereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper
In accepting this permit I assume responsibility for all work done by either, myself, my agent, sei .ut.. - employee.
BY
all ordinances and gulations
orities of Miami Shies Village.
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder •
Legal
Description
Address of
Building
Lot
1
MIAMI SHORES VILLAGE, FLORIDA
L - 1
�! PERMIT N° 9646
L.,
Work to be performed under this Permit
Bl.
Subdi-
visi
CONTRACTOR OR BUILDER BY
Value of
oject $
DATE - 195
Contractor's
License No
Amt. of
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 appl
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 thc: 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 responsibility for work
done by his agents, servants or employees.
Signed: ' BY
""." 1116EtTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in comftetice with all gtdinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities ;of Miami Shores Village.
pting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
•
HORITY
P COLT Nc'........ - - -- -
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or ot:ier
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. e
�-�
1
Olarnza'8 Name and Addreda - - _!! :._ // i. ] • ' r
� / -- -- - -. �To.� _ Street..-- -
-.-
Registered Architect and /or Engineer - ��- ,GC1�/'-- S .mss/ __✓- —
- -- -----•---------
Employing Plumber's Name
Locution and Legal Description Lot_ �,,
Street and Number where work is to be performed —No � - `�� a Street. 9'7 r
State work to he performed and purpose of building (By Floors)._ _ _ _
New Building_ -_. _ —. Remodeling_ __....._________ Addition
Size Septic Tank
Feet of Drain Tile._
Nature of Water Supply: City — Well.___--___ _.____ ....... - ._.__- _____-_____ ___-____Size of Soakage Pit
Amount of Penait $._
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No..
1
Street_.
Block Subdivision
Date.. - - / 70 7 - - - - --
Repairs No. of Stories. ...........
Type of Tank__ Capacity Gals.
.__Dist. Feet of Tank or Drain Field from Well
(Signed)-
Plumbing . actor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatiops as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, and has con-
plied with the provisions thereof, and will require similar compliance from all contractors or sub -con actors emplo by him in • ° work to be
perform <..! under this permit; and will post or cause to be posted for inspection on the site of the ork such public no. - •r notices as are
requred by the Act. The undersigned agrees to employ only such sub- contractors, o • work o be p e ; l. i this permit, as are
licensed by Miami Shores Village.
STATE OF P'LORYDA, es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fa'ilty
materials and /or workmanship.
CLOSETS
BATH
TUBE
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
•
SEPTIC
TANK
SEWER
CONK-
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
L
WELL
L
TE
SY
SYSTEM M
S
Pool.
—_ - -�
CONTR.
LIST
CHECK
I�
P COLT Nc'........ - - -- -
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or ot:ier
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. e
�-�
1
Olarnza'8 Name and Addreda - - _!! :._ // i. ] • ' r
� / -- -- - -. �To.� _ Street..-- -
-.-
Registered Architect and /or Engineer - ��- ,GC1�/'-- S .mss/ __✓- —
- -- -----•---------
Employing Plumber's Name
Locution and Legal Description Lot_ �,,
Street and Number where work is to be performed —No � - `�� a Street. 9'7 r
State work to he performed and purpose of building (By Floors)._ _ _ _
New Building_ -_. _ —. Remodeling_ __....._________ Addition
Size Septic Tank
Feet of Drain Tile._
Nature of Water Supply: City — Well.___--___ _.____ ....... - ._.__- _____-_____ ___-____Size of Soakage Pit
Amount of Penait $._
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No..
1
Street_.
Block Subdivision
Date.. - - / 70 7 - - - - --
Repairs No. of Stories. ...........
Type of Tank__ Capacity Gals.
.__Dist. Feet of Tank or Drain Field from Well
(Signed)-
Plumbing . actor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatiops as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, and has con-
plied with the provisions thereof, and will require similar compliance from all contractors or sub -con actors emplo by him in • ° work to be
perform <..! under this permit; and will post or cause to be posted for inspection on the site of the ork such public no. - •r notices as are
requred by the Act. The undersigned agrees to employ only such sub- contractors, o • work o be p e ; l. i this permit, as are
licensed by Miami Shores Village.
STATE OF P'LORYDA, es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fa'ilty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
./,� I�
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
' i;�
_ ' __ _ _
CONTR.
LIST
__._
CHECK
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, 1 lorida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be 1 ept at
building during progress of work.
Owner's Name and Address _
Registered Architect and /or Engineer
Employing Plumber's Name_
Location and Legal Description Lot
New Building
Amount of Permit $. -
ss.
//
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No. - - Street
Date - - - -- - -- ; -
Street and Number where work is to be performed —No Street __<<
State work to be performed and purpose of building (By Floors)
Remodeling Addition Repairs
( Signed)
Size Septic Tank Type of Tank Capacity Gals._
Feet of Drain Tile Dist Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
(Signed)
Subdivision -____
•r
No. of Stories 1
Plumbing Inspecto:-.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to he
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ ___
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fauli y
materials and /or workmanship.
•
, •-•
-";
e 4 ,/
'■•
7
Permit No.
Application is hereby made for the appro\ al of the detailed statement of the plans and specifications herewith,submittedJor the huildin� or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State if Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall he commljd.with,.whether herein specified or not. A copy of approved plans and specifications must he kept at
building during progress of worly'
/
Owner's Name and Address -_ ` -_ No Street
Registered Architect and /or Engi er -_ _'
J:
Employing Plumber's Name-"' ) �l " 4 1 Nb
Location and Legal Description Lot Block
Street and Number where work is to be performed— No
State work to be performed and purpose of building (By Floors)
New Building -- Remodeling Addition
Size Septic Tank _ -__ --
Feet of Drain Tile
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Mr-
MIAMI SHARES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Dist Feet of Tank or Drain Field from Well
Repairs
( Signed)
(Signed)
_ _ _�,
Date_ °
No. of Stories -_
Type of Tank
yp .._Capacity Gals. "
-- -- _____ --- --. -_- 'w
-
Plumbing Ins tor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an em dyer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeii red
My Commission Expire: Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TOR 'ES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
l OTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PI f
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
,
Permit No.
Application is hereby made for the appro\ al of the detailed statement of the plans and specifications herewith,submittedJor the huildin� or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State if Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall he commljd.with,.whether herein specified or not. A copy of approved plans and specifications must he kept at
building during progress of worly'
/
Owner's Name and Address -_ ` -_ No Street
Registered Architect and /or Engi er -_ _'
J:
Employing Plumber's Name-"' ) �l " 4 1 Nb
Location and Legal Description Lot Block
Street and Number where work is to be performed— No
State work to be performed and purpose of building (By Floors)
New Building -- Remodeling Addition
Size Septic Tank _ -__ --
Feet of Drain Tile
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Mr-
MIAMI SHARES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Dist Feet of Tank or Drain Field from Well
Repairs
( Signed)
(Signed)
_ _ _�,
Date_ °
No. of Stories -_
Type of Tank
yp .._Capacity Gals. "
-- -- _____ --- --. -_- 'w
-
Plumbing Ins tor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an em dyer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeii red
My Commission Expire: Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
ITEM
BATH TUB
UNIT
•
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN IMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
' U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 If
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 FP
`
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 FP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 FP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 FP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 FP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
.
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER- REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
._
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER -
FIXTLRES
SEPTIC TANK
ANTENNA
-
RELAY
TELEVISION OUTLETS
GRAINFIELD, 4' TILE/RES.
VIOLATION
! '
PUMP $ ABANDON SEPTIC TANK
REINSPECTION
`4
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
_
DOMESTIC WELL
AREA DRAIN
300F INLET
SOLAR WATER HEATER
=IRE
STANDPIPE
'001.
PIPING
-AWN SPRINKLER SYSTEM
1AS RANGE
4 ETER SET (GAS)
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date h J? Job Address C . Tax Folio 1 , Ar)(<-; C J � �) �k
Legal Description ' I J -�(7' C j t 64 7 1 1
Owner/Lessee / Tenant
Owner's Address
Contracting Co.
en 'OPctiocir,
State ( rCJ 01%3 Municipal #
Qualifier
WORK DESCRIPTION
Square Ft. Estimated Cost (value) k d( K -J
Signatur of a»ncr and/or Co
tary as to Owner :
My Commis r
sU AN . NESENMAN
MY COMMISSION # CC 860763
FEES: PERMIT
APPROVED:
Zoning
Mechanical
:XP►RES: Aug 4, 2003
1 .0063NOT.RY 71.1. Notary Service & Bondir.8 Co.
RADON
Building
P,umbing
Date
C.C.F. n 41 NOTARY '"
Historically Designated: Yes No V
Master Permit # 7 91f
P one , 3() s / ✓ 1 /
k Address • &O2 S ' /617-kiro,.17
SS# - , - Phone ;JL .'fit
Competency #IC/60 OIns. Co. (/ ?) ' 7Y (2)
Address
Address
Address
the er slat J ^
V
4 L�
gnatur• -'of Contractor or Owner-Builder
o
otary as r tractor A • � �r
My Co sslgpi kxp►r
j4, n' M Y cs MM .. ,, � ,
1 " 1 • PI # CC 860763
c ( X09 ':XPIRES: Aug 4, 2003
i 1-WO I OT,,RY Fla Not Service & Bonding Co.
Electrical
Structural Engineer
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICA PLUMB)MECHANICAL ROOFING PAVING FENCE
/e /Q L' l .tom °9a f `T° i)r&Th
TOTAL DUEy
SIGN
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR EVIPROVEMENTS 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 t do t work
1
lr (. ;v
Date
1
Date