802 NE 99 St (6)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date SA-747 Job Address v voz NE F' `.-s7 Tax Folio
Legal Description Historically Designated: Yes No 1r
Owner/Lessee / Tenant i_>/94,,�.0 C-A/
Owner's Address 2oZ NE 75 L '
Contracting Co. fir i4 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
rl
WORK DESCRIPTION � CC pf> v ' l�t r t
F
�-� ,dam, /� A ��vre" 0)1,/7
Square Ft. Ac-00 Estimated Cost (value) �7 er
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.
ignature of owner an
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date
My Commission Expires: - S d 9 -97 My Commission Expires:
FEES: PERMIT
APPROVED:
Zoning
Mechanical
RADON
Building
.r /
C.C.F.
Master Permit # / / LIS 0
Phone 7S' 9' 9' Z
Signature of Contractor or Owner- Builder Date
NOTARY BOND
Electrical
TOTAL DUE
Plumbing Engineering
Date:
** *
APPROVED:
Owner's Address
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date
Legal Description
Owner / Lessee / Tenant 77/3
Job Address (5 �� NE �9 T � S/ Tax Folio � &a0�p /It �46
7Z MI • Sec .2
Master Permit # 3c )q
Phone 7s 9 9 a 3 °Z-
1-07 1 J Y d , / A L L - / ,
G - A ,,�r; -.,
DID f
Contracting Co. W/ 1J2— iL /CJ
Qualifier /) A
..----•
State # Munic l #
Architect /Engineer
Bonding Company
Mortgagor
Permit Type(circle one): BUILDING
WORK DESCRIPTION
SS#
Signature of owner and /or Condo President
Notary as to Owner and /or Condo President
My Commission Expires:
Fire
Zoning Buildin
Mechanical Plumbing_
Address
Phone
Competency # Ins.Co.
hlO aS e- IQs%
Address
Address
ELECTRICAL PLUMBING MECHANICAL ROOFING
- c)`iZ
C ? e -/Z -2 (rPLE ArrAGHE a,
Square Ft. Estimated Cost(value KX 017
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.
Si
� •� • IkO
PAVING PENCE SIGN
ture of Contractor o:/ er- Builder
Notary as to Contractor orOwner- Builder
My Commission Expires: - Notarf Public, State of Florida
My Consninion Ettpires Aug. 16, 1994
Bonded Thru. Troy Fain • Insurance Inc.
FEES: PERMIT 37 5 : 0 • RADON C.C.F. ), OD NOTARY TOTAL DUE 4,Firi
Other
Electrical
Engineering