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315 NE 98 StPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ,> Job Address 3 / S 'Li/= e n 3-1 Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant 7o4 ) 6 F -) Master Permit # '10731 Owner's Address 1;4. , .4 , Phone S O - 6 /e Contracting Co. C 47 i' r r Address a Qualifier /6A--?z, r 1 (.r I P /7 ) Phone J / - C f 6J State # (' ACCT ,r�'� r Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING ROOFING PAVING FENCE SIGN WORK DESCRIPTION p,„ 0Ch7C / -c �-Q )J , r 19 7 /0 Ot°ir4p — 1c A-1 )/ /S r t/�17f Square Ft. / IA' 2() p Notary as to Owner and/or Condo President Date My Commission Expires: j6a4/ Yee 't FEES: PERMIT & RADON Estimated Cost (value) WARNING T r 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. _ M // V ature of owner and/or Condo President Date Sign tune of Contracto or Owner- Builder Date Ge------..-v4%-e-z-- „ . ) - - 6 o-z. N otary as to Contractor or Owner - Builder ate My Comx ns`sii�$ E p are s . , .. . 2 C.C.F. ° (Q NOTARY BOND TOTAL DUE 02 S 7 , 6e) APPROVED: Zoning Building Electrical Mechanic Plumbing Engineering MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date „L1 2 Time Type Permi .. 91 /7 t� Name , \ Address Company A / ,0 Phone # .3L O - 1r For Inspector:3,742 Nam � Z�z Approved � 1)4 � Correction ❑ Re- Insp'n Fee ❑ PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date ‘ Job Address S/cIVE Tax Fol io J) ,�O /(72 Legal DescriptionE / 'f /J yl m fg 4 •J /41/4,9Master Permit # Owner / Lessee / Tenant Ar- 4 /lag elL74- d;, 65_1. Owner's Address SOT / V` C lggA Phone %/ Contracting Co. S�G'�o 4IA . Address � � � — lb ;"114v, Qualifier et, Phone R ' WV 5 State# 60W ?iTIP Competencylfr &' 7g / Ins.Co. Architect /Engineer 4deae--( Address Bonding Company /00-1,-( Address AA'' Mortgagor /�dz0 Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION J:4/ %" j / �' � ( Sp/i r) 4 dt,4 -, c (F 6eJ ) Ca me ivel �� Square Ft. Estimated Cost / 1 75 9-4:- 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 f-Owuer and /or Condo President Dat -. 4I No ry a to Owner and /or ondo President My Commission Expires: * . * * * * * PERMIT FEE: APPROVED: Mechanical Zoning Fire J2 Building y c " k/ " bing Signature of C'ntracts i or Owner -Bu der Date: 6 , i q/ a �C / .. !.tr:. / . /el Notary as to Contractor My Commission Expires: * * * * Other Electrical Engineering 16 ner- Builder s :RM I T 0 .1 / 3 ,41, ate of Florida unty of Dade b. Interest in property: 2 M.3 (' I Contractor: (name and address) Surety: a. Name and Address 'ic 0 STATE OF PLORIDA COUNTY OF DADE 1 HEREBY CERTIFY that this is a true copy of the original filed in this office on_ ■ . day of , A. D. 19 WITNESS pAy hand and Official Seal. Clerk Circuit Cain BY Tax Folio No. 1/ l3 Ci5 �- /l /7 NOTICE OF COMMENCEMENT b. Amount of bonds 4 Lender: (name and address) /` D.C. Owner information: /. a. Name and. Address: ()4/' /6"" • (60. Signature of Owner 14)�75 as ?$i( .Ct •� a/. ; l 3 y z e (o-,zi-(1. E UNDERSIGNED hereby gives notice that improvement will be made to certain real operty, and in accordance with Chapter 713, Florida Statutes, the followirO , formation is provided in this Notice of Commencement. Description of property: (legal description of the property, and street address if ON ri available) • E /5- /L i L C 4 I / n''t - S �c, 1 (1 900 . N IX General description of improvement: �.Lk- 4/1/ 6✓L 4 )4 ��L V d ct` c. Name and address of fee simple titleholder(if other than owner): Persons with the State of Florida designated by Owner upon . whom notices or other documents may be served s provided by,ection 713.13(1)(a)7., Florida Statutes: (name and address) In addition to himself, Owner designates 't of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different'date is specified) 6 -71- t 21- orn to and subscribed before me this ( 7)\. day of . \v'1E , 1991. My Commission Expires: rj-Q,LI -Cik4