253 NE 99 St (14)Date
Legal Description
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Owner/Lessee / Tenant ), "...i..../ 6/7421
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Contracting Co .0
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Bonding CamPanY
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Co mpetency Zo
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Qualifier - or
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Municipal #
State #
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Architect/Engineer
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Mortgagor
Permit Type (circle one) ijp..,pk 1
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Owner's Address
WORK DESCRIPTIO
otary Own
My Conuinsii
FEES: PERMIT
APPROVED:
Zoning
Mechanical
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Addressy 2 5 3 4/ E 9 57tax Folio
Historically Designated: Yes No
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WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCE T TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FIN (NG, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORD/NG 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 Taws 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 foregojng informati�n is accurate and that a Nirork ifilt be cliiriehr cefripliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the abov&named contractor to dolhe work stated. P f;
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e of owner an
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ttife
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Building
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Plumbing
Date
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K 4 CO -ISSIONEXP. MARA
Master Permit #
Phone' 0 x 757: 7
Electrical
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My Commiss n ExpirenBECCA MITRA. I
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.." '-% • - ...) •-•./. .. mg a.,... NOTARY VLIBLIC STATE OF FLORIDA
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' RP. MAR. 252002
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C.C.F. 1 ' ' NO LARY is C. 'C't: 11I
TOTAL DUE L,O .....0-4•
Structural Engineer