920 NE 99 St (11)1 /A°
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PERMIT APPLICATION FOR MIAMI SHORES VILLAQE
Date 4/10/97. Job Address 920 N.E. 99th STREET Tax Folio 11 -32 -06 -011- 3/101;
MIAMI SHORES:
Legal Description TWO STORY ONE FAMILY RES: Historically Designated: Yes No NO
Owner/Lessee / Tenant ROBERT C . M T T , T , R R Master Permit # e-- g
WK:573 -4310.
Owner'sAddress 1270 N. E . 102nd . STREET .MIA SHORES .FL Phone RES :758 -5674 .
Contracting Co. \C //\ ( ! Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
engineer Address
Address
Address
pe (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
ESCRIPTIO PRESSURE CT,FAN_REPATR rRAru ,R,SFAT. WALLS PAINT SAMP:
O �G
Estimated Cost (value) $1200.00
TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
d YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
WITH 0 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
is h made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
all w rk will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
. equired for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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vwixitza AFFI e I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
law ating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signat e of owner d/or Condo President Date Signature of Contractor or Owner- Builder Date
ROBERT C. MILLER ROBERT C. MILLER:
(-
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date
My Commission Expires: Li / g 97 My Commission Expires:
FEES: PERMIT RADON C.C.F. 1 . NOTARY 5 - BOND
TOTAL DUE e)
APPROVED: / r
Zoning Building l Electrical
Mechanical Plumbing Engineering