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144 NE 99 St (5)
)(Date -CI:/ aa - 14job Address / i , 7% $ Tax Folio /7 0,6 13 044194 2 ,` /D Z f S S ' 7N 7 .z far g co c(� lOi / � Legal Description 1' �''� //� Sn os p ,4N►D, PLAT Boo K ,O P96, 7o g�� / Lessee / Tenant Q�oo Rk7iC Master Permit # "Owner's Address 7j Contracting Co. Pica Address Qualifier 41W Ai'rff SS# - Phone 75 -- r State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address )(Permit Type(circle one)). BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION #1°afIF P qi 1 FP/ 7- , f1xc 1 Square Ft. 157 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE l7 ( /Uk 5p Phone 7J- 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 informati•• s accurate and that all work will be done in compliance with all applicable laws regulating co t =c''on and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President Notary as to ■bs0Si4 QF et $Iittlitl- My Commission Expires: My Commission Et n score W DAVIS Y P .i * COMMISSION NUMBER 'W Q CC255237 -Fi << ci MY COMMISSION EXP. ** * * * * * * * * * * * kk �F °.t.1)? hl., -2 %,1997 *i1 FEES: PERMIT ,37SO RADON C.C.F. Mechanical Plumbing_ It-Estimated Cost(value) 1 J 02 S gnature of Date; © '/ - Builder NOTARY .5 TOTAL DUE APPROVED: Fire Other et: Zoning Building ' %/S6/9' Electrical Engineering D IIJILJG�1 LnvIkiC Roots ►��w poor. KITGHeK1 FL �14ov - 1 �L oOR (L,4 I� 1/4 - (f A1P R riov� PCR of wLL xt5 . Doo R FOR D l l g 0 00m ALL aD o Ra -AGE OLD Q R •