770 NE 98 St (11)BUILDING
ELECTRICAL
PLUMBING
ROOFING
a # a�
Owner of
Building P'# uc -
Contractor
or Builder s > •
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA V
❑ DATE `' 195
PERMIT N? 5134 Contractor's ?
❑ License No
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T 7
Architect
Legal Lot
Description B1
'3,
Work to be performed under this Permit
Subdi-
vision
Value of `>°
Project $ ?_
BY
Amount of 2
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 application
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 fora 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 responsibility for work
done by his agents, servants or employees.
Signed 4 r %•''ry,.' _rv� �_ °G BY •
INSPECTOR
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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY
6 14:4E-7
Date 1 f PnJob Address 7" D AI L 9 63 S ^% Tax Folio 1/ 3' /06 ® /l/ 23 /O
Legal Description Historically Designated: Yes No V
C� /Tenant 61Z7 Master Permit # 3 �f -®
Owner's Address 77 0 /J -L Phone X8'2 — lJt 7R
Contracting Co. m/9le /tiD.r Avg 1 1 , slic Address /0.3/ .sw / /ZA ✓d
lc n h p,,; a F( 3Tear
Qualifier klemtbit L Ma R.. 1
State # � a 13V-0
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Municipal #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFIN PAVIN FENCE SIGN
WORK DESCRIPTION WE £)C / S
.A 7
Square Ft. / t2 0 Estimated Cost (value)
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 d. e in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do
Signature of o
N.ary a
My ommission Expires:
Personally known.
APPROVED:
Zoning
Mechanical
as/4
or Condo Pres ent Date
/ �. - t
er and/or Condo President
FEES: PERMIT 90 . op RADON
9'4
ate
O �pRY P0 OFFICIAL NOTARY SEAL
MARIA P ROMERO
1lf * COMMISSION NUMBER
• '►U't`• a CC360236
Q SAY COMMISSION EXP.
OFFP9 MAFL 29 . ,i998
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SS# Phone& Swb 1/3Z - 53 7 3
,awry,,• t No . Sg0 - /S/ z
Competency # Ins. Co.
/ _62)V V ECc1,9
Sit, at re of Contractor or Ow ; - Builder
Notary as to Contractor or Owner - Builder
My Commission Expires:
C.C.F. NOTARY ' TOTAL DUE Yom-
Electrical
4
CA) In4
Date
Date
Plumbing Engineering