874 NE 99 StDate . • Job Address S 7 9 - 9 9 s % Tax Folio
Legal Description
Owner/Lessee / Tenant
Owner's Address S7 / /✓t 99 sir"
Contracting Co. S //'/$ G'Oj2 /2,
Qualifier ,�Ai)7,C=5 1/ SS #. Phone .340:5 - 5797
State # Municipal # X200 O Competency #.'2000 Ins. Co. 82 2 '7$
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION /A/ST9CG 6 " /.a.9.5.6 -v ' / " / 7107- /.t
/9v'H/9G T
Square Ft.
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,-•�'of owneudior Condo President
-q0- 41,3k/
�• as to Owner and/or Condo President -
y Comm ission Expir OFFICIAL NOT
NOTARY PUBLIC STATE CG�� A
COMMISSION NO.
MY COMMISSION EXP. MAR.
N
FEES: PERMIT
7a6>
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
RADON
z
/1,r.
1 ate
C.C.F.
s /hz s Phone 637- 3 790
Historically Designated: Yes No
Estimated Cost (value) /96.7
0
ture
s
eve =�'•
sion xp1DYS 1 VILLAR
NOTARY PUBLIC STATE OF Fursit A
COMMISSION NO. CC714103
• u - IO EXP. MAR. t 002
Not.
My Comm
/d30 5W 66 Syr' pr76h'
Address ""e. 0302 3
f Contra or or Owne
NOTARY
APPROVED:
Zoning Building
Mechanical Plumbing
Master Permit #
Electrical
TOTAL DUE
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Date
Engineering
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Miami Shores Village, Fla.
OWNER 41-e/a a DATE 3 - ? f
ADDRESS 7 `'1
INSPECTION ,,- -� F. 7rtj�✓ 4)._1-i°- Le.
.cJ�c� -1
TIME READY
Z�
PERMIT NO.
CONTRACTOR
TELEPHONE NO. 3 - 620 S7 7
INSPECTOR
Miami Shores Village, Fla.
OWNER
DATE 3 7 " �y ADDRESS g ? / u
INSPECTION
TIME READY' /'
PERMIT NO. 7rat
CONTRACTOR
TELEPHONE NO. ) of - Z � P?
INSPECTOR
DATE 5),°.