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860 NE 98 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204 Date `P I Job Address Wig i1/4)i -I sI' Tax Folio Legal Description /Z 4 COf 4 / 4(1 - �fi - Historically Designated: Yes No tito 9 0 0 " 1 a8 I Owner /Lrezee/Tenet ' cr ® o oY i� - 2 Z V ° Master P erm i t # Owner's Address L " IN qg S‹. Contracting Co. P` - r�� Qualifier -30} L e State # Q 6 C 011 c.^,1 O $ Municipal # Competency # Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE 13 $50.0 AND MUST .IE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL WORK DESCRIPTION: ?P46-12. em-:b 1 Sit, s Square Ft. 1 bO 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 ANY 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 all disciplines. OWNERS 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, oning. Furthermore, I authorize the above named contractor to do the work stated. X nature of own FEES: PERMIT APPROVED: Zoning Mechanical Notary as to Owner and/or Condo Presidpgt My Commission Expir z it%, Patricia L. White �Cotntnission # CC 946000 Expires July 30, 2004 Bonded Thru Atlantic Bonding Co., Inc. RADON Plumbing Date SS# Phone 30,5 70 l i ) W Address .SL8 ij 1 4 ) d INV& F4 I- i F1 .33300 PLUMBING MECHANICAL ROOFING d ated Cost (value)0 7/ 3 fr L1./c i Buildin / >OLureeoZ/6.4.,-f Contractor or Owner Builder Phone q L ? 7C' _ I / D 8 va tiM Notary as to Contractor or Owner Builder My Commission Expires AVkYa Patricia L. White 4' ;; , :Commission # CC 94600P �� : e E rpirea J uly 30, 200' ...�� 0 ru i g` ; Banded Thru ' ',, � •`�� Atlaatie Bondin Cc C.C.F / ° 0 NOTARY BOND _,, TOTAL DUE eg " / Electrical I Structural Engineer Date Date