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DRIVEWAYPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 17 7 Job Address � (A) 6 s Tax Folio Legal Description /el' 64,A / 2 y Historically Designated: Yes No Owner/Lessee / Tenant .4// n ).e. /l Owner's Address it f u 73 51 " ,f/1 ; 44; 5 A-D e. Phone(3D,li 5 75 1 G‘ 53- contracting o.4 7% 4 C ��11/ Gf % P Address L the 1 �7 . g / �y�� �- J Phone 3o.y R8 37 So 0 State # Municipal # Competency # 4 ' 7 Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION P/4 C K 1Y4 / 4/1, P.,Q Square Ft. CI f 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. Notary :"o Owner : s c or Condo President Da My Commission E . es: Mechanical Plumbing BuildnigkkI*1 Master Permit # G �� Afn20A64 .fieco 9) Estimated Cost (value) 7, 7 r ontractor or Owner -Bu Date Signature o to C. tractor or Owner - Buil My Conuniss on Expir A: NEGEN s r FEES: PERMIT RADON C.C.F. / e 0 NOTARY © _-- BOND ,7? 00 APPROVED: TOTAL DUE Zoning Electrical 1 -15-1 cc, Date Structural Engineer V • J Scal 1" - 20' L^'t` —Ii''s awn. er -- -- 'vw- .-- 'n.u..:�M < •.a�� -� p � a Ep • PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain Chapter 713, Florida Statutes, the following infomtation is provided in this Notice of C 1. Legal description of property and street address: ./ T » /Yaf' , I e - �D � 4 -v/✓t, 2. Description of improvement: !%/•i via 1'Vz/ i/1 �,,7 / -A tq /',e' ,1,'6 , 7 6, r2 G // _ivy o ( - ✓. . 3. Owner(s) name and address: /4777--f /`fir , ?2,/ 5/if ;e6'v7 - 7 3 3 / < Interest in property: I9 / p7. ' /'- Name and address of fee simple titleholder: /`. 7/ �/-2 // S ; /V1/ 9V2--.} j1 / r; �'��Pv7 '* 3 / 5 Z 4. Contracts name and address: 1/7 / er __:,----. 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 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) Notary Public Print Notary's Name My Commission Expires: Signature of Owner Print Owners Name Sworn to and subscribed before me this iv 1 1 -t ur - Lu1 V 11 VIENuLIVIE N i 40.4./.4 n,,, f7P.A . ! Ot� A lt c i'lC j ;L pRID;'o C k;e� co uY � Allis '� o,,-I• i* nnrl C ^u ^cv Cou ric ! Cl�r G C. 99R385427 1999 JUL 26 09:134 real property, and in accordance with ommencement. 4 s• 7 /`4u./72/f- 5-e // 5 ' tikes .(% Prepared by: J t )6,t/ Address: 77 01 V (V . �. 0 1L-- ,' fr