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* M I A M S H O R ES*
MIAMI SHORES
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MIAMI SHORES VILLAGE, FLA.
JOB
ADDRESS /17
INSPECTION /
TIME READY
REMARKS • --
INSPECTO
R e-e*-:rz. )
N? 5876
- -c V
DATE
Date l.0
FEES: PERMIT
Sion Expires:
t1-0,
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 1/ 7 / /V J Tax Folio
Legal Description i - ► 023 ‘ 0,0GK. / TO Historically Designated: Yes No
Owner/Lessee / T e n a n t E1 / I c... s CIN. Q_ 14.t- ct,1 f Master Permit #
Owner's Address // / / /V / 44 /L 331 3h ne C s 75V/2
Contracting Co. U .5_ MC K D SLF/Ck / INC - Address 9`// N- 5Ort alb / k jN,
Qualifier J /,6Y 'gONA SS# Phone 05v) 7 1 of " On re- 3 .w7
State # C&C # 050335 Municipal # Competency # CG # ?0/ aa0 Ins. Co. 14C-C eg D /A
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFIN (kPP VING NCE SIGN
WORK DESCRIPTION x6/1-01- -�Of� cTF £ f$T /N6 Ap/7 a PG2/( nr Nj -U$((/J6
( ,2/cK P,-Vi 5 x en Y ,P i C6 (5 ( /4
Square Ft. // 9 Estimated Cost (value) -
J " 7D
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 OF 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.
Co
gnature of owner and/or Con President Dat
1 11 as t t o wner and/or Condo President Dat
, Jeffrsy Abbott
i (,Commission # CC 739016
Expires May 3, 2002
OF A- ATL ANTIC BOND NG CO.. INC.
RADON
C7/7
v
APPROVED:
Zoning Building
Mechanical Plumbing
: 1 ..
��f o tc or or Owner - Builder
ssion Expires:
0.10% Jeffrey C. Abbott
i Commission # CC 739016
�n� Expires May3, 2002
( c BO NDED THRU
"' 6 PITtr f NC
C.C.F. 3.6 0 NOTARY TOTAL DUE <e‘a
Electrical
Engineering
•
/ 7 er c )a• 741 .. 4 53rbe 7..
J2107 . 1214/./..
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