399 NE 98 St (13)Owner
Dati Job Address
Legal Des criptio4,'f goZJ o5 J yI
/ L ee / 11e l'A I■i r i
Contracting Co. 4
Owner's Address
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Qualifier SS# - -
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOPING PAVING IGN ' h/ 140,..eake.,
WORK DESCRIPTION- je.A6 iI _ �i bVl I/tQ El?/3 ti t 0 Lc1,
cco
Square Ft. Estimated Cost(value) 2DC)
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
be done in ••,�` nce with all applicable laws regulating constr
authorize t -named contractor to do the work stated.
Notary as to Owner and /or ondo President
My Commission Expires:
** *
APPROVED:
* *
FEES : PERMIT ier 0
* * * * *
C.C.F.
RADON
Fire
Zonin Buildin
Mechanical Plumbing
N tf' /c_ Tax Folio /1 ,v6 13 -- _caoJ
Address
777,gg,e,/
Master Permit #
337
Phone '7 7(- &t'1(
Phone
s accurate and that all work will
ion and zoning. Furthermore, I
7
natur
Date : 4
I _
/ tart' as to C
y Commission
t- . sJ NOTARY pt2
n ig�Gor Afui lder
r � �•
i� %. ��:id038rq Public. S�IQ C1AOndt
• Na mum
TOTAL DUF, � J ( 50
Other
Electrical
Engineering