MECHANICAL, PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
•
Date S 9IZ 7 /a/ Jo b 6 4 N£ ,- Tax Folio I 3 0O o , y
-Sec 3) " ` ,�,u ' 1
Legal Description flL ,/J 4,q4, S'/16rij, Historically Designated: Yes
Owner/Lessee / Tenant ,4 ' /" 4 CA ✓G $1' Master Permit #
Contracting Co. S.► 4/. 1/ g f e ( 6N(• Address 3 9 S. Lo 4. FP ///te; F4 33/34
Qualifier E b itit (4 10 O - IA 2 G? LA--t
State # E IZ- ON 4 g ,"_i / Municipal ll
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRIC PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
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Owner's Address
WORK DESCRIPTION
2i(
Notary as to Own and/or Condo President
n Date
My Commissi ri: E fires: .....
FFICIAL NOT
RAMON
NOTARY PUGi:IC TA FLORIDA
COMMLSON Nh. CC750205
MY COMMISSION EXP. UNE 1 i s 002
FEES: PERMIT /Q d RADON
Phone
SS# - (a cs) 4-4-3 - 8R Q13
Competency # q¢E00004 - 4 Ins. Co.
Square Ft. Estimated Cost (value) 300. 0-0
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.
'Signature of owner and/or Condo President Date
Signature of C or or Owner-
Signa Builder
No
C.C.F. TARY BOND
TOTAL DUE ( t
9/.364)%
Date
APPROVED:
Zoning Building
Mechanical Plumbing Structural Engineer
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MARY MORENO
ir744 MyCornntsion Eaphis Dec 10.2304
4.1,4 Notcay Pubit -State of Amid°
Sroof Commission # CC979510
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PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
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Date / /2 4/ Job Address no • 446 99 Tax Folio ) 3oS � b 0 I ,
C � 1
Legal Description w 9 2 4 k `� $ 6 / b
!;� P � S/��.Historically Designated: Yes No
Owner/Lessee / Tenant ► Mi. f "iC C4 „ o 7' Master Permit #
Owner's Address ! ! S 44 , A • � �D 4ps • Phone Ear/ 7SF' / / ,0
Contractin Co. (4k £' Z4Je ? I' _ t Addressf Ai) 17 9 fL(r a `, P V /?
Qualifier P4+1. fe ( G ,4►
Z S S # P hone /T -3f��
State # C- bee —? 2.3t? Municipal # Competency �� 71 q a_
3 pal petency # ns Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBINGIMECHANICAL' ROOFING PAVING FENCE SIGN
WORK DESCRIPTION —WV-0 1 / /ter L41 &`.i 74f't f /4 Y1 • 2 Syil.0"i r •
) 14//9 4. /qti 4 G
Square Ft. Estimated Cost (value) 6000 -
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
construction and zoning. Furthermore, I authorize the above -named contractor to do the t: ed.
;. Si ture"ofownet.,and/or Condo President Date
"."-Notaty_as to
' My epitunisSion
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FEES: PERMIT 2.4
dJ
APPROVED:
Zoning
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- xpizes. RAMO” 1 1 °
NcijrARY PUBLIC: ST >- O' 1 ' 1 .. ORIDA
CAMMLSSIO ",j sir) (.7502
MY COMMISSION Ext'• UNE 10 2002
I
to
RADON
Building
Signature of Contractor or
Mechanical 6 l .v r Plumbing
Notary as to Contractor or Owner -Buil
My Commission E
Electrical
TOTAL DUE
C.C.F. , P7 NOTARY ` b - BOND
a .plicable laws regulating
Wir
er- Builder
s: OFFICIAL NOT:aRY SEAL
RAMON LOPEZ
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION Na, CC750205
MY COMMISSION EXP. UNE 10,2002
Date
Dale
Structural Engineer
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w 'NOTICE OF COMMENCEMENT
'A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commericeme t.
1. Legal description of property a d sire t address: g .
2. Description of improvement: ... // Cwt *Pt s2 5.7 f /a9—ii
3. Owner(s) name and address: /tit C_ZL 4// 66144J a_C 2 e�
.v. r. st / 1(• s-bil ws
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: (/V i✓ SY
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
ture of Owner -
Print Owners Name r� HA/ � C_ C G 11447
Sworn to and- subscri ed before me this
Notary Public
Print Notary's Name
My Commission Expires:
'a_ Fir 37 fia
STATE OF FLORIDA, COUNTY OF DADE
o PfE03aB y CERTIFY that this is a true y of the
� il Mal fit d in this office on
� �__ day Of
0 20
WI SS my hand and Official Seal.
1 r UVIp, „ .... or Circuit and Coumy Courts
by .:w
D.C.
01R533497 2001 SEP 28 12:07
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Prepared by: 0. L_Ar P 2
Address: ( 2 -2 -1/ - 4s79
r a /z1 ^
123.01.52 2/93