866 NE 99 St (8)Date 121/ f''S Job Address t l o o i l L. q Sr' Tax Folio // 3 Za /¢ 242c D?
sr /. 4 L) 7- S 0-c c.� c.0c.. Z
/ /So•o A- ! o I 111) / 5-7 •
Tenant"-�l� �2 fjtia•..t s ta r __ Master Permit #'
Legal Description,� Y7 c 4 .
SPla
Owner / Lessee / Tenant
Owner's Addres s
Contracting Co. � r4*es Address `77 C-247-100,4 4 R /_ ✓� /car)
Qualifier 5;P- 7 v ��
R icrrmo pis SS#2- Phone 3c- ac=s
S c3
1i
State o55''�dMunicipal # Competency
Architect/Engineer , �r 0...le
Ni/�
Bonding Company
Mortgago n iY Address ____M £ rte» � 5�ir •c -t r� .
WORK DESCRIPTION
Square Ft.
ignature of owner
Date:
** *
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
. BUILDIN
Permit Type(circle one
a d /.or Condo President
'4;.. JOSEPHINE CHURCH
a 'L 6 l tw.�� ! 7 , . ' : ma y P+ Iic 61444
ary a to Owner and/o , � :• QMi oirobt lglq. April 3;0, 1996
4 .
My Commission Expires: •, « $,O No.CC191545
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
A 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
b• done in compliance with all applicable laws regulating construction and zoning. Furthermore, I
a tho • contractor to do the work stated.
FEES: PERMIT i/ RADON C.C.F.
APPROVED: Fire
Zoning Buildin
Mechanical Plumbing
Address
Date:
tary as to Co
y Commission Expi
! / ' 131" ""'• JOSEPHINE CHURCH
Cont
V r T �,1; r : !OFF �,}}
1
4 Mo. CC197545
one(3'5 ) 7521 - 7995
keAka C 5'SSGd Ins . Co .
/3 L.A,•f n_
Address kid g5"2.5c- Am-WA= Ft. 33147
NOTARY + o o TOTAL DUE OM
Signature of Cogtrac or or r- Builder
* * * *
30, 1991
Other
Electrical
Engineering
ITEMS
SUB CONTRACTORS & SUPPLIERS
N; IiE & ADDRESS
1. Architectural Fee lans
,, �'.� _ y r / s
2 As•halt walks drives etc.
, _., .� i/ :.1 %• ! .
`-
3. Cabinets - Bath Vanit
4 Cabinets - Kitchen
ILMIW ; «R
,
5. Cabinets- Medicine
6. Cabinets - Unit Closet
,
7. Cleaning
f,.� ! ✓/i1 1 ._' .. •
k
8. Clearin• Site
/
9. Concrete m Foundation. Slabs. Beams;(
_
f� ��41 .
10. Concrete ® Walks drives. etc.
11. Contractors Fee
t T
12. Electric Fixtures
ri PAW/14 e 6/� ,� M Q_
'
��,
..7 _f
13. Electric Vlirin:
% - %� ■: r
14. Equipment Rental
15. Excavation
16. Fill for Slab
A? tali > . • , r
17 Floors o Finish wood & kitchen
_
'I
18, Floors m Terrazzo
l', �, 9 �r �. ,G,
19. Gara:e Doors
• / �il 01111111
j� •-�. rte :
20. Glass Slidin: Doors `
1 tJ / 4 _ 1.MO
21. Hardware - Finish
, -_,-
22. Hardware - Rou:h
rl 9 �e
23. Heatin: , ('•
rar _ _ : :? . t om /1T Mi _ .Q atA•
24. Insurance - Liabilit corp.-bond
7 !' 1
2 5. L Payroll
I/,ff ., 1 ,, ..
v
6 or - Contract
27. Labor ® Contract
IIIIIIIIIL
IIIIIIIII4 A / A
28. Landsca•in. Fill. Gradin
29 Lath Pl Stucco
a t� r/ ? : ' ` - an r ' "' > wi
pr
30 Lumber (All
31. Masonr Labor
_i / ,, 1. • • ,^ i
32. Masonry Materials, Block
33. Millwork
=�
34. Miscellaneous
35. Ornamental Iron Work
36. Oven & Plate - Built -in
, ��°
_
_ ' :�. rile' 1 6 :
� - ��� ;'
37. Overhead
38. Paintin
39. Permits Temporary Power
1 v f
p'
VIr -`1, .r l/
/
40. Pilin: (Foundation)
,,� '
41. Plumbing Complete
W(, /�!�T- "1 %3° / , " a
y
Pool �wimmtn •
42. _
A 9 4
v
43. Roofing & Metal Work
r� . ,_ L _,s � ;; i� . ' '-' i
_ , �fi/ _
✓ ��
•
44. Roof Trusses Pre-fab.
45. Screen Enclosures
/. ; t � %;
•
46. Se tic Tank or Sewera:e
,
'
47. Shower or Tub Enclosures
48. Steel ® Reinforcing & strl. eAliaNgir
x ,� / j . w; %_. _
49. Su ervision
50. Surve s
1771 t_W ...: r .i i'L .' .
51. Tile & Marble
f A .I►
52. Water - Public
;
53. Mater - Well & Pum•
�l,�Vii# l ..r' ;'.1� , _ �''� f�.
54. Windows - Glazin. & Screens l �
,
V
55. Window Frames - Concrete
OWNER
LOT
BUILDER
cl�
IMIAMI SHORES VILLAGE
APPLICATION FOR FINAL INSPECTION
- Prior to a final inspection this application must he filled out; if sub contractors have
failed to take out permits the general contractor shall be responsible for the permit and
fee. A final inspection must be made prior to the release to Florida Power and Light Co,
and the issueance of a c: tificate Qf occupancy.
JOB ADDRESS
SUB.
DAY LABOR CONTRACT DATE
56. Builders Bond Must Accompany This Application for Final Inspection.
TOTAL