PAINT4'.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 212 - 9 Job Address b3 JE 101 s4 Ste Tax Folio / 3 a o5'- 019 - O 220
Legal Description 1YtiQtw∎ SLc re.S Sec .8431 3t t . 11 (, /PR k3 ( Historically Designated: Yes No
Owner/Lessee / Tenant C4 r ti Fli Pq(�(JCt,,S Master Permit # .,
Owner's Address (1 (p 3 ME 10 ( S c4re�� Phone 77‘-, - 139 7
Contracting Co. ■_) Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
WORK DESCRIPTION
Square Ft. Estimated Cost (value) 000
Application is
certify that all
permits are req>
OWNER'S AFI
laws regulating'
Signature of oV
Notary as to Ov
My Commissioj
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN Y MIfl PAVING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WI PE 'R AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
°rmit to do work and installation as indicated above, and on the attached addendum (if applicable). I
meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
TMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
ie foregoing information is accurate and that all work will be done in compliance with all applicable
thermore, I authorize the above -named contractor to do the wor . ted.
Date Signature
Date Notary as to Contractor or Owner - Builder
My Commission Expires:
Date
,0),R0' P0 OFFICIAL NOTARY SEAL
2 , ,.. , SCC'iT W DAVIS
t 1�; * COMMISSION NUMBER
@� _ . 1 ; Q CC255237
7 i k* " �� MY COMMISSION EXP.
F Oc � � JAN, 26,1997
FEES: PERMIT RADON C.C.F. ) NOTARY TOTAL DUE t \ - li , 'e
APPROVED: �f
Zoning Building 1 L3 b
Electrical
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 2-- z7-91 Job Address /K5 /1/e /a/ Tax Folio
Legal Description
e /iI 2G4F,� Master Permit # 37440
Owner's Address / 7 /Y." 7/ 9;
Contracting Co.
Qualifier SS# - - Phone
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 7(f'/-/ /,79 ( /577/V ado c-194.-- OA/ //'61(7,2&
/4 !°f><rc ✓ /&wr Pa9/Z3 (X4/4/77
Square Ft. 57 SQ F Estimated Cost(value) ,r5
7 �D
Lessee / Tenant
Signs re of o el'a4id /or Condo President ig
Date: Dat
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * * * * * *
FEES: PERMIT /1050 RADON C.C.F.
APPROVED: Fire
Zoning Buildin
Mechanical Plumbing
Phone OC
Address
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 accura e and that all work will
be done compliance with all applicable laws regulating con uction - % zoning. rthermore, I
author he aboveenamed contractor to do the work stated.
'ontr =cto o Owner- Builder
•
Notary as,p0Y 6gnt 10 rmvamOwoux :uilder
My Comm " • . (�,, i $ * M MONTIEL
} 'i `t» COMMISSION NUMBER
Q CC401281
17 ,.. c * MY COMMISSION .EXP.
t 4 C) F\• O AUC# 171098
NOTARY ' 5 ° TOTAL DUE
**
Other
Electrical
Engineering