1196 NE 98 St (9)Date 9'25-92 Job Address I l% ice . 135T
LT. zy 6LK, IRO SECT *8
Legal Description
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/ Lessee / Tenant Pullin
Owner's Address I I I ( w e. t;. Q8
• -I ST.
Contracting Co. (A.5. I1 I1,K INC.
Qualifier JAMES s. eoNc
State #C6050805 Municipal # Competency #
Address
Address
Architect /Engineer
Bonding Company
Signature
Date:
APPROVED:
NONE
NONE-.
Mortgagor NONE Address
Permit Type(circle one) ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
13e i c►k P i c t v o z D R vEUJ
BUILDING
WORK DESCRIPTION J,NS1 A LL
Square Ft. 1000 T
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
aut the
410511° ed contractor to do the work stated.
and /or Condo President
Notary as to Owner and /or Condo P esident
My Commission Expires: Berta Feman z, Notary Public
State of Florida
My Commission Expires 5/29/95
** * * * * * * * *
Master Permit #(1(3/77 -
Phone 757- 1 523
Address c141 )4. 5TfIrE 20.1
PIJWTi T(0N , Pt_. 33317
SS# - Phone f38Q - ?)OUC'
Estimated Cost(value)
Fire
Zoning Building
Mechanical Plumbing
Tax Folio I 1 32O55()I8O'f 10
Ins.Co.
#2100
re of Contractor or Owner- Builder
or Owner-B .er
Notary as to Contractor
My Commission Expir
b*rta Notary
State of Florida
* * * My Commission Expires 5/29/92
blic
FEES: PERMIT 3 r056 RADON C.C.F. /` NOTARY TOTAL DUE Vg/44
Other
Electrical
Engineering_