301 NE 98 St (4)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 7 - / - `127 Job Address ) C S + Tax Folio 11 Q. 6 13 5 b / 0
Legal Description ' VV 7L 0" f I( ? G K 1/
Owner / Lessee / Tenant Dan I e- 1 G roSSWo Id - F F 11ZGtbe-I'ttc-1 "Taster Permit 4f 5A�q 7S�
Owner's Address 30 I 'r. q S 5+. M I Ctt vii 5�ior S R . -55(3g' Phone - 751 - ,, a4c,.
M ob..k - 5 - t S'i
Contracting Co. Cold C.O1 + foyers oVerS Ih . Address(G,t15 SW 1177 Ave . S ±e Z6 A
Qualifier SS4E - - Phone a 3 ^ CJ 5 6 S
Co sol i c(a° 4e cl L-'lop� ° +�tj
State IPCGC D�,��7a7 Municipal # Competency #(2(v5O! 6 Ins.Co. eaSiva 1 t CD •
Architect /Engineer N /A Address
Bonding Company Al J /4 Address
Mortgagor MI - 1 9 0 ft an e Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVI FENCE SIGN
WORK DESCRIPTION Zns - II brick paves as Veztd 0(1 pia
Square Ft. 150 6
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 in compliance with all applicable laws regulating construction and zoning. Furthermore, I
authorize the above -named contractor to do the work stated.
Signature of owner and /or Con ent
Date:
Notary as to Owner and/or Condo President
My Commission Expires:
** * * * * * * * * * * * * **
APPROVED:
FEES: PERMIT -- t = - � - � 5 19 RADON C.C.F.
Estimated Cost(value) 1 g 0 D
Signature of Contrac
Date:
or Owner-Builder
Notary as to Contractor or Owner- Builder
My Commission Expires:
NOTARY TOTAL DUE %Sr
Fire
Zoning Buildi : I11! Electrical
Mechanical Plumbing Engineering
Other
0
RE'6IT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Q
Date 7- i /t Job Address OI
131ui%2onA siz .4(
£L iz 1 s57r f.c
331 Nr% st f , l Af . t 4 S tr 46
Co. Ce., � ✓ ak..-007/>12./e1 '" — U( _. Address
0%00a0:01 SSf _
Legal Description
Owner / Lessee / Tenant
Owner's Address
Contr�_ct ing
Quali :ier
State fr
Mortgagor.
Square Ft.
OWNER'
vi 1
F
Signature
Date: C
Notar< aS to
Ay Commission
* * ,
:ERMIT FEE:
Architect /Engineer 4
Bonding Company �i/�.
Permit Type (circle one): BUILDING
WORK DESCRIPTION t'
Compete.ncy/ ! a( SO /—
ELECTRICAL
Address
Address
Address
Tax Folio 32 01 (G
Master Permit #
Phone 751' 606
/ //S S) 1/7. - ..P L cYee9
Phnna
Ins: Co.
PLUMBING MECHANICAL PAVIN
Estimated Cost 4�
FENCE SIGN
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.
FIDAVIT: I certify that all the foregoing information is accurate and that all work
ompliance with all applicable laws regulating construction and zoning.
rize the a• e-named contractor to do the work stated.
0 09eosep s
o o• tPRY P ° o
rliE3� �� a
o
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o ', 71r
x res: py,...
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oFTI
APPROV "8 MAE2 Fire
Zoning ts57 Building
wner and
Expires:
Mechanical
Plumbing
Date: \
of Contract
Notary as to Contract
My Commission Expires:
* * *
Other
Electrical
Engineering
( 4n
• �
41
0 x '.0 31
OFFICIAL. NOTARY. SAL
MARIALENA RAM iRn%
COMMISSION NO. CC2773I6
MY COMMISSION EXI' MM 1,1997
w
; PREPARED
MUM TECH-
= STATE OF
TIVE CODE)
3 TRUE AND
ND BELIEF.
EMBO4SED
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THE FLORIDA
SOCIETY
PROFESSIONAL
LANG SURVEYORS
FOUNDED
1955
SCALE: 1" _
REV:
REV.:
REV.:
DATE
G -21-9
3976-
ORDER NO.