51 NE 99 St (11)Signature of owner and/or Condo President Date
APPROVED:
Zoning
Mechanical
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Building 44 g tph°
Date S - 78 Job Address 3 ,(/ Z 9 sr Tax Folio /
Leg al Description Historically Designated: Yes No 1/
Owner/Lessee / Tenant t•'1 QS. ICA PLI 14441R Master Permit # `i 2 S-S—00
Owner's Address Phone '75 C) Sr-6 /
Contracting Co. Q vkAIE 1e Address
Qualifier SS# Phone
State # Municipal # 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 3 / I-1r6 t4 'woo) FE /- IC E
Square Ft. Estimated Cost (value) qT zs4-6,
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
laws regulating construction and zoning. Furthermore, I authorize the ab • e -named contractor • d
the .. t , ted.
` a ��•
Contract •r :r er-
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date
My Commission Expires: My Commission Expires:
(iY PU OFFICIAL NOTARY SEAL
Q �P e li SANDRA C3 MONTIEL
2 — * COMMISSION NUMBER
CC401261
; MY COMMISSION .EXP.
AUG 1 °q _... <u
FEES: PERMIT 4"-/ RADON C.C.F. 1 0 NOTARY
BOND
Electrical
e in compliance with all applicable
uilder Date
4 ' - n e r - 1-, 5- ?,8
TOTAL DUE 4—fu
Plumbing Engineering
1
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1
BUILDING ❑
MIAMI SHORES VILLAGE, FLORIDA .
t cy f
ELECTRICAL ❑ Date Y � 19 _`.:
PLUMBING ❑ PERMIT N? 10725
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building ,
Architect
Contractor
or Builder
Legal
Description
Address of
Building Zt.
Lot
• - t
Subdi-
vision
Sq Ft.
Value of
Project
$
Contractor's
License No.
-
II Amount of
11 Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employeed: 7
1,
Signed• " 6 h `'(INSPECTOR) BY
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accfpting this permit I a sume *responsibility for all work done by either, myself, my agent, servant or employee.
Yf�. „�++�.: ter. � ��� at:.,•...,r�
CONTRACTOR or BUILDER BY AUTHORITY