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816 NE 99 St (10)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) - Job Address N g -S • /�1 (4 +' S �¢ 4 lCJ i Tax P0110// 0 ,461 4 / ' a Legal Description / / ?" /1 '7 `7S LeA5- Master Permit # Iio Owner / Lessee / Tenant /hoer-+ W, G-1;6 Owner's Address ei 6 N F qa £'f. l •fi t•►1 l •,StiOre Contracting Co. Rcri 7.I/ G hono .f CSC ©P Ad dr e e Ls /V etic4, C N- ttir /skit / (4 Qualifier 3 t t b 1)11_14 Fl A-0 phone 6 87- / ?Oe' State # .ev/Ft Architect /Engineer Bonding Company Mortgagor Date: ,v`-D N 6- ,vD A/P Competency# c Ob ©O /e.7e9 Ins. Co. 6-Goi ,. //�- c �l ' cfe Fire Mechanical Plumbing Address Address Address PERMIT FEE: APPROVED: r�, '� Zoning Building / ', / Elec phone Permit Type (circle one):c$UILDIN) ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION Q &p / f P,yn P,i l (t v Square Ft. Estimated Cost it 4.(5,m jl2 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and M R ic, I ,AEMA. (o& /� P10TA C MY COMMISSION EXPIRES: Dec. 29, 1999.. OWNER'S AFFIDAVIT:BDNTDEt'filii- mimic i U all R thee f or ng information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, 0 ` authorize the above —named contractor to do the work stated. ila18?nic ' ./I ?' � "`� ���7w CTION G, : Cy$ ; OORS & OPENERS, INC. A�J�J81e0 --. , X `� � ±� �' / / �/�� � h ' _� J / / ,President Signatur- of Owner and /or •o T Presiders igna / fure of Contracto / or Owner- Builder STATE''OF FLORIDA On thist;the 20th day of _ bh, 1992, before me, the undersigned Notary COUNTY OF DADE . PublicQof the State of FLorida, the foregoing instrument was-acknowledged by::' Jack D. Pilafian of Action Garage Doors & Openers, Inc., on behalf .of - the corpor lion . Notary as to Owner and /$r Co do ut sident Notary as to Contract r Owner ilds tl Commission Expires: ° r45 e d : F' _s th ' * * p ires * P4tS 1�,6 My Commission pines: J _ Othe PR P06, .FICIAL NO ' AY SEAL 2 0 t �� � ,�l� 41Af11SELLA SALADO % COMMISSIO 1. C ya e • C C 143 4 6 ➢� � ° MY COMMISSION EXP. r( *lt.o Engineering I • • • • I ME MIN MO I • .. 11 En. 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