ALARMDate . ' • Job Address /0•V' /a/4 if /f • Tax Folio //' 3 ` ° / ' -242 7
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant ' , y , &-#'-d /D Master Permit #
Owner's Address 4 /+/; f9 7 Phone �/
Contracting Co. 4 & A Address �.7‘ f / ' ') /5?
Qualifier DG P,-/1t.9
State # 44✓��
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BU
L PLUMBING MECHANICAL ROOF
WORK DESCRIPTION
Square Ft. Estimated Cost (value)
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 . • 1 work will be done in compliance with all applicable
laws re: lating construction and zoning. F ermore, I authorize the above -named con : cto to do the work stated.
Presid
resident
Date
, :,
JUIJO ROBLES
;,:
h i :.= MY COMMISSION # CC 921872
5 � EXPIRES: June 4 2004
f,ii Bawled Thru Notary Pubk Undemdlera
�l,IL
Sign a of owner and/o C., • •
Afi A „.
Notary as • •
My Commis •n
FEES: PERMIT RADON
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Municipal #
C.C.F.
SS# ' Phone .-fa'
Competency #
Address
Address
r JULIO ROBLES
iP
° MY COMMISSION 0 CC 921872
W. EXPIRES
Aezh, Bonded Thru Nota Public ' 2004
Ihgawdten
Signature Date
Notary as t
My Commis
APPROVED:
Zoning Building
Mechanical Plumbing
tra • or or 0
on Expires:
NOTARY
Electrica
Ins. Co.
G PAVING FENCE SIGN
BOND
TOTAL DUE
Date
Engineering
Date
Legal Description Historically Designated: Yes No �j
Owner/Lessee / Tenant � (� h eA f-C % �- Master Permit # /( 7 y
Owner's Address / 1 A / / P Or: 33 / Phone
Contracting Co. . /6J / S �!� ' � ' Address 5 N!) /.P
SS# / Phone 3 ��yr
Qualifier / /4g4f
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address /4 /1/k Y., 01 Tax Folio
State # 4 Municipal # Competency #
Address
Address
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. Estimated Cost (value) /it q
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
FEES: PERMIT 3 RADON
y v/789
C.C.F.
Ins. Co.
Notary as to Owner and/or Condo President Date Notary as to . °- `r''""��'?t'6!r "" U "°�� Date
My Commission Expires: My Commission Expires:
NOTARY BOND
TOTAL DUE 3 6 e
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering