600 NE 98 St (8)Date
Dat
** * *
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 606-4/z" 5?,9 S 7 Tax Folio / � /AW /7 AOW
Legal Description ' G & j je �� � Pfi' l e
Owner / Lessee / Tenant 619 /e/ S Master r Permit # 30
Owner's Address (m en ' tier ' V /70,9 4 - / 2 :6' Phone s 7S7' 6 9 3 7
Contracting Co. , / >. )Y'7/ve ' Address 1 / / / -/ 47 %c4/ ,
Qualifier aiee;I C/-/ZiT Phone -' GIC
State #4 Municipal # Competency 4fr Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION Gl/ /2d✓,/e s /5%leed:6 4 w
P'lfrs p?b & ✓(C e-s / o{ /fie yeA -,
Square Ft. Estimated Cost(value) 9.20• 00
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
No as to Owner -!'d /o Co do P
My Commission Expires: � IZt � ��
President
_ Q + nni+ t
IRINA CONIGUO Dat
Notary Public -State of Florid
My Commission Expires
esidentAWCIst 21. 1995
CC138088
as to Cont =ctor or Owner- Builder
7�c Cidkaatt.
re of Contractor or Owner- Builder
ission Expires:
PEES: PERMIT 6 RADON C.C.F. NOTARY TOTAL DUE
APPROVED: Fire Other f�
Zoning Building
Mechanical Plumbing Engineering
**
Electrical
•
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: OD /✓E 9 ,!}� f /
// /, , /' / U / — PA /5- y
2. Description of improvement: c-- �57//9Z D/ `L 2C4. SS f1�, „c✓ S S���/
3. Owner(s) name and address: e979/1.4'...S - - (GIJ/ - d/ C • 99S T
`d /
Interest in property: GL/rs✓e'
Name and address of fee simple titleholder: CJ�ev 2 —•
4. Contractor's name and address: 4 ,/,4/S �/jo7F77 'e ‘ - //// -.76m e & /.
/?7 /i yvz: ,i% 33769 - Sru 4- �53.
5. Surety:(Payment bond required by owner from contractor, it any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes.
Name and address: lT rte✓
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address: NONF
9. Expiration date of this Notice of Commenc ment: (the expiration date is 1 year from the date of recording unless a
different date is specified) 3 O
Spnatur. of owner
Print Owners Name , 44 -ALX'J
Sworn to and subscribed before, me this
Notary'Publi
Print Nota t o VOA -
My C
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day of
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93R333193 1993 JUL 06 13:48
Prepared by:
S� c S
Addi s: / /// r�i` ' C
IRINA CONIGLIO 1 B - 6 ' —
Notary Public -State of Florida 33 , 6 5' sue, 54 )!s-3
lity_ Auugust 1 21 n Expires
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