146 NE 98 St (6)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address '4' / % s' �r ' Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant k /F 1'1 vc?(;a,e.ek -Q >, W)
Owner's Address ,/ fr*/ , ,i,� C.`" 7o • 4 -=
Contracting Co. 7\ Du) 1 . 4 J0, W
Signatu, of owner and/or Condo President
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT fQ RADON
APPROVED:
Zoning
Mechanical
Address
Buil t � /i(j
ding
My Commi
Address
C.C.F. ' &70 NOTARY
Master Permit # 9s
Phone s, A S - Jt 1 -16
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor
Permit Type (circle one):( BUILDING) ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
.44A.
t ev't (.2 ev_ t arwvs
Square Ft. Estimated Cost (value) >( /o4:1)., !i)
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 ify 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.
` Date d S gnature • f Contractor or Owner - Builder Date
Ad_ d7 �'Y 9/7/77
Notary as to Contractor or Owner - Builder Date
SE
.11 ' OFFICIAL NOTARY AL
Air , , ;j o�CC7 7 �� AS
l� �4 DEC. 17,2002
Electrical
BOND
TOTAL DUE 4/s
Plumbing Structural Engineer
10C`,/ l'1/180
Pc. t:a Condre
10GY 83/125
Mezcla de la Mariana
Melange du Matin
1OGY 83/100
Arroyo
Eau Vive
Morning Blend
W14
Springwater