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386 NE 99 St (6)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date "(� / ' q 5 Job Address 3,5 G ii/ s Tax Folio /7" 307®G -D /3 — .51:s7.5" Legal Description % / Historically Designated: Yes No te� K � t c�cu4 �Z. pp •�' Owner/Lessee / Tenan �� /vB� � Master Permit # � p Z � .� Owner's Address ? �" /`� /= 9 . Phone 7 5 3 y y .S Contracting C/, b " Co tic Address / 74`-0 /`1 L 6 7,,7O Qualifiers¢4•e 5 aA SS # Phone ‘S:" State # Municipal # 7/ 4" 7 Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFIN PAVING FENCE SIGN l�'n WORK DESCRIPTION ./Z-- ds`' . „or/ ' Square Ft /.1Z' Estimated Cost (value) 5 - 6 - 1) 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 Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: IFEES: PERMIT 101r' RADON C.C.F. � NOTARY ature of Contractor or Owner- Builder Date )J 6 1 - / - "ZS - Lary as to Contractor or Owner - Builder Date My Commission Expires: TOTAL DUE fr0t APPROVED: Zoning Building / C 1 P / 4 ) 1 , i Electrical Mechanical Plumbing Engineering Date Legal Description '-‘7 Owner/Lessee / Tenant <Xsy,.i Master Permit # Owner's Address SeC /- 4 99 .{f Phone 7.5 — 4 , 4 - , $ Contracting Cor.l;tyre cz G .//L . y �v „� 0 4 c- Address // d ,e/..6 0 4'O V. Qualifierj6* s C/A- o State # Municipal # 7/ 1 7/, Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION / J ■zc 1,4.3,- /f.A, ..cc-. ice 4?9s , e y r Square Ft. / 3' 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. • .,, �. . 0,84111 • mr §§ o x ifacIAL NOTARY SEAL < SANDRA M MONTIEL 4, ) . COMMISSION NUMBER ,:IN' I CC401261 7 i� `r` - 4 MY COMMISSION EXP. OF F\ AUG. 17 1998 Signatur��6 owner and/or Condo President Date of My C • PERMIT APPLICATION FOR MIAMI SHORES VILLAGE FEES: PERMIT APPROVED: Zoning Mechanical Job Address 3 O /`l .5/ Tax Folio / / --3.7e54 -0/ 3 0,5 RADON //&<- Date C.C.F. Historically Designated: Yes No SS# Phone ‘S ' 3 0 Estimated Cost (value); .573 om c Q CC401261 is MY COMMISSION EXP. OF FA AUG. 1L1996 -£5 tgn ure of Contractor or Owner- Builder Date eN 5 Notary as to Cont. *actor nal muggs i�ld D to M y C iofiC c aciAL NOTARY SEAL 0 <i SANDRA M MONTIEL *i+ * COMMISSION NUMBER NOTARY TOTAL DUE Building Electrical Plumbing Engineering