1208 NE 98 StDatq / q ' ) J o b Address A / J S 1 / C
Legal Description 1 j
Owner
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
Owner's
Contracting
Qualifier
Address I -- (;(25 14C gg5t
Co.
Atte
State#
Architect /Engineer
Bonding Company
Mortgagor
Permit Type: ROOFING BUILDING E C RIC PLUMBING
WORK DESCRIPTION
Square Ft.
/(/
4, Dov-,( ,5 -
WARNING TO OWNER: YOU MIST RECORD A N0T I CE OF COMMENCEMENT MO YOUR FA I LLRE TO 00 SO WAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEIOER OR AN ATTORNEY BEFORE RECORDING SUCH NOTICE.
Application is hereby made for a permit to do work & installation as indicated. I understand that
separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, & 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 toning.
Furthermore, I authorize the above -named contractor to do the work stated.
A BACKFLOW PREVENTION DEVICE may be required on this
property. Call the Public Works Dept. ASAP at 787 -1001
or visi their office at 1815 Ni rtheast,, . 150 Street.
.. I tir �r�
Signature of Property Owner or Condo Pres.
Sworn to & subscribed before this
of , 19
Signa ur
(Print,
Personally
TYPE OF I.D
t # ,NOTARY SEAL
' AL. •'! 1T ; ,_ • :
Type,
Known
1
. PRODUCED
Zoning
LiCe,'1 se
Competency #
/C
day
110 Y OhniCrAO Hrldb F9y&t id
My Commission Exp. Sept 7, 1995
Commission No, CC 134560
or Stamp "Lo`mmists loved Name)
OR Produced I.D.
p ax Folio // So UoVe
hh / Waster Permit # tUV Z
Tenant
��/M/Day -Time Pho 7 - ! f
Address / � U (/ ' C. l' c� 7
SS# -
- Phone
4 79(5 - We e Ins . Co .
Address
Address
Address
MECHANICAL
Y -(;;/, /44
Estimated Cost
Signature
TYPE OF I.D. PRODU
ED
t9)
nature of Contractor
Sworn to & subscri before me this
of _ , 19
Notary to Contractor
/7//d JJc/ '`' :�L�!�'J(/B /�•,,� •
(Print, Type, or t4np. � 4 peg Name)
Personally Known : ' :! 14 ti .
ACC 249708 : e
Mechanical Plumbing Engineering
PAVING CE SIGN
11 x
7 8 7 (
IS
0 Electrical •
Date - 41 G (Q-a- Job Address 12o%3 N L' `B J T Tax Folio
Legal Description eA 2c.F Ta,J SI tj or /o 3. 3 P3 q3
Owner / Lessee / Tenant V ‘ A \ \ -4-3-%.J?- Master Permit 4V
Owner's Address 120 1.4 C g ST
Contracting Co . C- 1JZ . D"otT0:3.0 2- 'e'caYLS Address 9 s k 'Z( 0
Qualifier2 -r■T ` CM- SR Phone J2 - 7 47
ex) 2 .`r t v7ofr o
State 4# 'Municipal # Competency # Ins.Co. `'Ki�►a� �tac.c�t
Architect /Engineer L \‘t
Bonding Company
Mortgagor
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHAN;.50 ROOFING PAVING FENCE SI N
WORK DESCRIPTION r -r /o &Li/ oe�5
Square Ft. Estimated Cost(value)4/W
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
Date:
Notary as tc Owner
My Commission Expires:
* * *
FEES: PERMIT 40 `
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
,
and /or Condo President
NOTARY PUBLIC, STATE OF FLORID/,
MY COiViMISSION EXPIRES: AUG. 28,199
BONDED THRU NOTARY PUBLIC UNDERWRITQRDR
RADON
/.S
Zoning
Mechanical
Address
Address
Address
s__ L
11- 32o5- o - o3Coc
Phone 1S8 TSZ B
Signature of Contractor or Owner- Builder
Date:
,A /i4 `'7� ;
Notaryy as to Contractor or or Owner- Bui
C lder
�
O PUBLIC $,T ATG OF 1,OR1DAa
My 4 .f��t 1+, -0.Th L� R,411::� 2a,1991
BONDED THRU NTAR
NOOTA�3t 7, : ' L0; 1011
coi.ii.i: iiO ?: t LICES: Pk!C. !WYl
BONDL:D THRU NOTARY r'UULIC UNDG , J: t;L:r....J
* * * * * * * * * * * * * * **
C.C.F. / NOTARY TOTAL DUE
/4 ®O
Fire Other
Electrical
Engineering
Plumbing