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ALARMDate !V 2-3/q Job Address 1[63 N.E. ((( Legal Description / r 54r7r? S wee g iev r>3 4 /3-G/ Lessee / Tenant &Q r'y /4 . Papp.5 A 100 y ,.5.ferlert..5 Master Permit # Owner's Address ( 16 3 /V r rn / S f . Phone 37a — C7() Contracting Co.\ AiOrry ( J P(+ Address : AJ . !.0 . ` Z ,4-4/t1 `4 !d4 Qualifier 2 f Ghat( 5e pa 1 vedc SS# - - Phone 1- 1 7 / ` 7 `t D O State i ( • Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION r9 A tares Square Ft. Estimated Cost(value) l O 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. Signature of owner and Date: Notary as t PERMIT APPLICATION FOR MIAMI SHORES VILLAGE President Tax Folio I I 32d5 © 1c] OZZO 1- fla DO C P Signature o Date: Q. My Commissipn Expires: My Commission Expires: 371 .5 tr or Owner- Builder er and /or Condo President Notary as to Contractor or Owner- Builder ** * * * * * * * * * * * * * * * ** FEES: PERMIT " RADON C.C.F. NOTARY TOTAL DUE 51 APPROVED: Fire Other Zoning Building Electrical f1 / 15 Mechanical Plumbing Engineering Date .1 Description / Lessee / Tenant 6A)9 /'// Aim f4/4ijC,7 Master Permit # Phone ( A)) 39.2- — ‘70 2 0 Address 3� ts., ('"' '''``c *leg Owner's Address //63 PERMIT APPLICATION FOR MIAMI SIORES VILLAGE Job Address //IK AA /'" „Si - Tax Folio / / �� c�,C 0 /7 AA,Q ) Alt /o/ Sr . Contracting Co. Qualifierl2N.1 C C?-0 ss# - State # Municipal # Competency # Architect /Engineer Address Bonding Company Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTIONS r•'■PS� r�(7-- Square Ft. Estimated Cost(value) wr:�1(ZING 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, andt 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 d co ractor to do the work stated. Sign•ture Date: FEES: PERMIT APPROVED: RADON Sig Da Nota My * * * * * * C.C.P. Phone 4 1 --- Address NOTARY TOTAL DUE Fire Other Zoning Building Electrical Mechanical Plumbing, Engineering Ins.Co. r or Owner- Builder lder **