WALLFEES: PERMIT 60
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
1 O 1 Job Address t N T\ ,(..
Date � �o ( � • � � 5 Tax Folio
Legal Description
Owner/Lessee / Tenant Pi_ O vsJ 1sA M . (S t M fH"
APPROVED:
Zoning Al 5 / �/D I Building
Mechanical
Plumbing
Historically Designated: Yes
RADON C.C.F. v NOTARY < V O Z
Master Permit #
Phone
No
9 g /
Owners Address L Co ( , F , a Q, -c S - t. Phone - 40c - 1 — 7110 - 4-
Contracting Co. Address
Qualifier SS#
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 L.
WORK DESCRIPTION VDU `l. C o F4—. 1 F c N-J 1)(6C
cw��ce �kt5`tN(r -ii \ �S A iN-S 0 vi ST4 R-ee •s1ANOthi(r S(-G-4
Square Ft. Estimated Cost (value) Ck,S0 a�
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.
for or
•
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate : % that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor t o the work stated.
Signature of owner and/or Condo President Date Sisk e of Contractor or Owner- Builder to
D - a s s _ )93- 6-b9f O
/ •_:_
Notary as to Owner and/or Condo President Date Notary as (, Contras r - - �, gate
My Commission Expires: My Commission Expires:
S
bsyr OFFICIAL NOTARY SEAL
B!, ANGELA M BECKER
* OOMMISSION NUMBER
' CC786697
ft4s FLC cp MYP OWSSIOU EXP ES
Z 165 Electrical
Structural Engineer
STATE OF FLORIDA)
COUNTY OF DADE)
Further, Affiant sayeth naught.
The undersigned Affiant, O� does hereby attest that the
(property owner)
attached survey, performed by L a 1 Q5 4- (5 &Cl A \ OC .
(name of surveyor's company)
performed on f q—S , is an accurate representation of the existing conditions and
(date of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as a : • licable to this or other permits..
Affiant/Property owner
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this day of DO
D
Affiant is personally known to me, produced l r i, l � f",�S ?CJ3���� sidentification.
0
O , 01Y /)z, ANA €6A fA BECKER
{� �� + # � * ...., tON NUMBER
Q a C786697
4*. MY dOMKISSION EXPIRES
1 3– rs
NOV. 15,2002
STATE OF FLORIDA
) SS.
COUNTY OF MIAMI DADE )
F-
STATE OF FLORIDA )
) SS.
COUNTY OF MIAMI DADE )
(ACKNOWLED GEMENT - INDIVIDUAL)
The foregoing instrument was acknowledged before me on
, who is personally known to me or who has produced
as identification and who did (did not) take an oath.
Signature of Acknowledger:
Name of Acknowledger:
(Typed, Printed, or Stamped)
Title or Rank:
Serial No .(if any):
(ACKNOWLEDGEMENT - CORPORATION)
The foregoing instrument was acknowledged before me on by
, of
a corporation, on behalf of the corporation. He/She is
is personally known to me or has produced as
identification and did (did not) take an oath.
Signature of Acknowledger:
Name of Acknowledger:
(Typed, Printed, or Stamped)
Title or Rank
Serial No.(if any):
1161 .E. 98 Street
JOB: Extend existing cinder block wall and install (2)
freestanding galvanized steel gates -
Prepared by :Donald Eisenman (owner)
lis prbperty described as:
)t 19, Block 179,
VISED PLAT OF MIAMI_
ES SECTION 8,
-co to the Plat
lereot, as recorded in
lat Book 43, Page 69
F the Public Records of
tue County, Florida.
- )te: Underrjround
lcroachments and
tilities, it any,
- )t. located. Fence
4nership by visual
'art only. logcli
dnership not
.
LOOD 7,0aE: X
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L4o.: 120
"eni No.. 93 Suff:::::
:.te of 1?.1.R.M.: 3-2-94
Llevtio•: Not Available
10
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:Liiied To. Guic:3c.ream
,]isenmann, Donald M. and
Aay Claudc, and
ontinentai Trust Mortyage
ompan: its ,Alcces.sors Lind/or
Lo,
Eisenmann. Don lo M. and
PROPERTY 01 Hamelin, Marie Claude,
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1161 N.E. 98th Street, Miami Shores,
Florida
L. ANNES and GARCIA, INC.
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(305) 666-7909 (305)523-86fil
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TP212765
ADC212
WGD
2936
0 :1. R F-a.0 rJWIt_"Fc4kF,RS
OF MIAMI
3670 N.W. 79th Street INVOICE
Miami, FL 33147
Phone: (305) 691 -7711
Fax: (305) 693 -1386
www.AnchorMiami.com SHIP TO:
DSC
DONALD EISENMAN
1161. NE 98 ST.
MIAMI SHORES ,FL.33136
1.00 F21'TOTAL °X 4'OF 1X2 RECT. #263
1.00 F9'TOTAL X 4'OF 1X2 RECT.#264
2.00 2 1/2" x 7" .065
2.00 2 1/2" OD. ALUMINUM DOME CAP
2.00 WHEEL GUIDE WITH DOUBLE ROLLER
3.0.0 V- TRACK "TO BE BOLTED 19'10 "LEN
A FINANCE CHARGE OF 1 A % PER MONTH WHICH IS AN ANNUAL PERCENTAGE OF 18% WILL CHARGED ON
PAST DUE ACCOUNTS, PLUS ALL ATTORNEY FEES AND COURT CO ST- INCURRED DURING COLLECTION.
TERMS NET 30 DAYS. NO RETURNS ON. MATERIALS. ALL SALES FINAL .
«COUNTER COPY»
00216867 NET
228.0000
177.0000
7.2800
.5500
27.5600
35.6700
00117555
04/30/01
1
228.00
177.00
14.56
1.10
55.12
107.01
Amt Tendered VISA 684.57
AMOUNT DUE 1�