234 NE 99 St (9)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
1 0 ` 0050 N.E. }nd Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 305- 756 -8972
Date � l AC/ --'Job Ad / dress O( C J' f ' cr 1' Tax Folio
Leval Description
essee/Tenet
ner's Address
Contracting Co. Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
WORK DESCRIPTION:
otary as OvAR
My Commissiot
Permit Type (circle one). B DING ELECTRICAL
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 ANY 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 all disciplines.
OWNERS AFFIDA 'IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulat'' g c. ruc on a; zoning. Furthermore, I authorize the above named contractor to do the work stated.
ar; 2
ent Date Signature of Contractor or Owner Builder Date
la 'M t3
bndo pres
es t 0048
y omm.ss
Expires November 15, 2006
RADON
5I2.9)
Date
Historically Designated: Yes
FEES: PERMIT
p
APPROVED
30
Master Permit # Tio Z 0 03
(I 61
Phone
la9r)
MBING MECHANICAL
No
ROOFING
Notary as to Contractor or Owner Builder Date
My Commission Expires
C.C.F V NOTARY cl/) BOND
TOTAL DUE " ( 0
Zoning Buildi Electrical
Mechanical Plumbing Structural Engineer
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 6/2/2003
Applicant:
Owner:
JOB ADDRESS: 234
Contractor
Local Phone:
Parcel # 1132060134340
NE 99 ST
Fees: Description Amount
FEE2003 -3335 Building Permit Application Fee $60.00
FEE2003 -3336 Notary Fee $5.00
FEE2003 -3337 CCF $0.60
9 Permit Status: APPROVED Permit Expiration: 11/29/2003 Construction Value:
�p Work: INSTALL A FOUNTAN AND A LION STATUE ON PROPERTY
r
Signed: ' _ �T -i (INSPECTOR)
In consideration of the issuance to
conformity with the •fans, drawi •s
done by either my
Building Permit
Permit Number: BP2003 -887
Contractor's Address:
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOT 8 BLK 32 LOT SIZE SITE
Total Fees: $65.60
$360.00
is permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
ents or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
or employes.
Signed: (Contractor or Builder) BY:
Page 1 of 1
Total Fees: $65.60
Total Receipts: $0.00