899 NE 99 St (4)04/02/1992 07:57 7514097
NOV 2 - 95 THU 15:06 KERTZ SECURITY
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Fotiidi:T,rye (cimie one): Pd111I,DIN LEcrB cAI. JLITMBINQ MECUANICAL ROOFING PAVING FIERCE
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PERMIT APPLICATION I'()R MIAMI SHORES N"iLI.,:AO[t,
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Municipal 4 „_,, _ Compctlsaxv 4 !nut. C
Address
Address
Square . �._... = stL'ttated Cost (value) _ —... ,.,._.___ --, _...___
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WAR NING TO OWNER: YOU MUST RECORD A NOTICE OF COMNiKNCEMENT AND YOUR FAILURE TO DO SO M:
RT.SC YOUR PAYLNG TWICE FOR IMPROVE1I :"TS TO YOURPROPER'IY (IF YOU INTEND TO O$TAIIN YLNANC11
CONSULT N't illl YOUR LENDE OR AN ATTORNEY 8EI'ORE RECORDING YOUR NOTICE OF COMMENCl "s1YfXNT.)
Appiies:son i8 hereby in to obtain a permit to do wort: and installation as iudieated above, end on the attached addendurtt (if applicable:
ctatif that all work will be pc to meet the atnadards of ail laws regulating construction in this jurisdiction. I understand that scpa
permits ire required fbr ELECTRICAL. PLUMBING. SIGNS, POOLS. ROOFING Lind MECHANICAL WORK.
Ot AR'S AFFIDAVIT; I co:ufy that all the foregoing information is accurate end that all wort: will be done in compliance with all anplic
laws rcgc rating construction and zoning. Furthe:rnore, I authorize the above -named contractor to do the work stead.
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FAX N0. 3055232363
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It :lone14 IN,)sit hated: l �'� - -- No_,.
Signature of Contractor or
.'otary as to Contra
My Commission E.
Master Permit 0 _
wncr•Builder
PAGE 01
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SIGN
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AttfAdi_
0. 4115- 3IR11(lliaL OTARY SEAL
SARINA M HIRSCH
�r. * COMMISSION NUMBER
CC34864G
7 ' r �4� MY COMMISSION EXP
Op fe` MA 14a13
ate
Date
ih•ly aS t0 , �
Myl Gurtmt lobo ' N OFFICIAL NOTARY SEAL 1
1 . <i SARINA ,�1 HIRSCH
• I COMMISSION NUIBEFN * CC348646
9j P MY COMMISSION EXP
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