DRIVEWAYSPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date /61 - / 5 ( Job Address /7 y /(f C l
i/g(alc /4,51 shirec„-r
Legal Description
Master Permit #...313PL"W
Owner's
WORK DESCRIPTION r
Notary
My Co
APPROVED:
Lessee
Address
/ Tenant
/ 4 / ���9
c.
S�.
Contracting
Qualifier � .d,0X-1/ /e'
State #
Architect /Engineer
Bonding Company
Mortgagor
SS#
Municipal PP
S nature of owner and /or CondoIre`s'ident
Date:
Condo President
+"$ &ft,,x AL: NOTARY SEAL
<- SANDRA M MONTIEL
't * COMMISSION NUMBER
sa. alp. -� Q CC401261}
4 MY COIRMISSION .Exp.
Of F U 17 1998
FEES: PERMIT iiiV 4 ' RADON
Zoning
Mechanical
* *
Fire
Buildi
Plumbing
Address
D
Nota
My C
Tax Folio
Phone ?$ 7 0
Address 7/ ?/ NzJ ?6 s
Phone g k07,Z
Competency # Ins.Co.
Address
Address
Permit Type(circle one BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Square Ft. Ala, 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 that all work will
be done compliance with all applicable laws regulating construction Ind zoning. Furthermore, I
author ^ th• above -named contractor to do the work stated.
Signature o
ntractor or Owner-Builder
as to Contractor or
ission Expires:
r4N[� 3 L,t) --
D
OF 5i`peu/AC4
;; .«Y P ��-•,, JOSE N. ALFONSO
?. th MY COMMISSION 1 CC 214098
* * - �: BORES: July 1 1998 *
- Doodad Thw Notary Public Undommtem
C.C.F. 14 NOTARY TOTAL DUE
er- Builder
*
6
Other
Electrical
Engineering
A. J. WATSON
it
- �( S��,N cal 1 r�
2__ T� orI °p d►vi, n+
SURVEYING, INC.
7875 Bird Rood Suite 225
Miami, Florida 3.155
Phone 266 -1894
99TH . nlr
LP.
r
12.4'
1 STORY C.B.S.
rt 144
of LOW FLOOR EuVA77W -12.55
23.5' c
X 15.7'
28.0'
m
A
5'SIDEWALK
14.r
15.8'
75.0'
SKETCH OF SURVEY
SCALE : 1" - 20
cT