SLABAPPROVED:
Zoning
Mechanical
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 5 1 3 / � i la Job Address 1 2-f6 fi) t . S S C • Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant
Square Ft.
f4 1. /t st6 , S
D s1_3 is
Signature of owner and/or Condo President ate
Building
Master Permit #
Owner's Address / 2-8C9 N E. 7 s- /- Phone 7 7 r O 3
Contracting Co. cm_( i (L . Address
Qualifier SS# Phone
State # Municipal # Competency #
Architect/Engineer Address
Bonding Company Address y�
Mortgagor C 4 vc,1 -e �(Vt �,v� Scc�� Address (id- rl t4J D n �l
Electrical
Ins. Co.
Permit Type (circle one):DIN( ELECTRICAL PLUMBING !! MECHANICAL ROOFING PAVING FENCE SIGN
T
WORK DESCRIPTION 44' 5' JA o -ex-t. 5 I-i , /3
Estimated Cost (value) e 1 0 D • 0 0
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.
h, D -S--
Signature of Contractor or Owner- Builder Date
3 r6
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date
My Commission Expires: My Commission Expires:
u. . :. :! s"30TQRV a'n6
TWA r_ @^1TIT6
3 76, g'
:. r (� "7t ;IBS:: ,�M •E11P.
�� a 'u9: 3 _
FEES: PERMIT 0• RADON C.C.F. t, _ NOTARY TOTAL DUE
Plumbing Engineering
7
Ammimmummwmimilmor
This property described as:
The West 50 feet of Lot 2 and the East 50 feet
of Lot 3, Block 2,
EARLETON SHORES,
according to the Plat
thereof, as recorded in
Plat. Book 43, Page 80
of the Public Records of
Dade. County, Florida.
Note: Underground encroachments and utilities,
if any, not located. Fence ownership by visual
means only, ownership not determined.
rLoop ZONE: X
/70'
i -
v.1)
PROPERTY oF:Sherman,
Not valid unless embossed
with Surveyor's Seal.
- 93 ._57`fee
9.9 S7
Dana R.
A BOUNDARY
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SURVEY
I hereby certify that the survey repre-
sented hereon meets the minimum
echnical standards set forth by the
Board of Land Surveyors pursuant to
SectiOn 472.027, Fla. Statutes. There are
no e croachments, ovOlaps, easements
app aring on the. plati ,bth th as
sho hereto. ' 1 j
6 ,
) 111. Reg. Lan Surveyor No
. 01Ve(709.1 J .
4
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and Sheman, Alan D.
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Certified To:
Town and Country
tr o ci p
1286 N.F. 99th Street,:
L. A N ree'4 r;.: F a r A t , d i l C.
ENGINEERS - LAND SURVEYORS - LAND PLANNERS
Office address: 359 Alcazar Avenue, Coral Gables, Florida 33134
Mailing address: P.O. Box 561131, Miami, Florida 33156
DATE
SCALE
Ter/ise .--
4 /1 7'd 377
(41641* 50 i r
5 &/-4 5
4
C A /// =/50
Title Guaranty of th
Hollywood, First
American Title
Insurance Company
and/or Commonwealth
Land Title Insurance
Company, Sherman,
Dana R. and
Sheman, Alan D. and
Circle Mortgage
Corporation, its
successors and/or
assigns
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PIM(' T: '7( A/19 (4
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DRAWN BY DRWG. NO
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