1155 NE 100 St (11)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date C `LC — V Job Address // , /0017 Tax Folio f£7aS /9 5 /�J/r
Legal Description Go r i/ �/ C r - ,Y71-0,17/614/ _C � y� ' � aster Permit #
Owner / Lessee / Tenant /v_?, 4 vs ",1 o C fe4CY -✓ ,Zb11
Owner's Address //fir- 'V'' . /0 O S 7
Contracting Co. /1 O-.74 (, r '. G Z1 c-ti �•
Qualifier d' /Y G %*
State #
Architect /Engineer
Bonding Company
Mortgagor
Phone ) • ti9
0- K d / r %?oi ?/ ? t i - / c c .
SS# Phone ‘f2
Address
Competency# PitfC Wei Ins. Co. 6
Address
Address
Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING
WORK DESCRIPTION %: � ' � 0 i G fl, d/c / 7, - 7- 7e 4I4/f 0-`-/
7 Cl ice W77// o-t /F Gi o-/ 4'7 rtQ/4- .z77 .7 -/'C
Square Ft. Estimated Cost 900-0o
SIGN
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 o the work stated.
ERMIT FEE:
and /or Condo President
lotar /as.i/o Owner and /o Co d President
.y Co ission Expires: , j /6/ ,
* . *
*
*
APPROVED: Fire
t oning Building
Mechanical Plumbing
(S : nature of Contractor or Owner - Builder
Date:
N
My
*
404
aryo as to
Commission
*
)zOi
• R -
i
de4?
ontractor r er- Buflder
* pires:}f 44 A
*
Other)
Electrical
Engineering
A le
•:4
4I6(00S
Art w ft woof ` -4C!
V •
p •
Wilt-1 • /y-12_1- Apt i V it/10 4 c jJ
// s:r '�� , / ff f/ .
l
e- f_C etC_ , < b � /fi , u' . 0 2 / tr.) AL-1 !..r/70 � �
•
THESE PLANS ARE APPi;OVED FOR
ISSUANCE 01' A BUILDING PERMIT
VARIA■:. ^.E(S) t!STED IN "REMARKS"
:': - - :-.'I S''! ES! BUILDING A' :D ZONING
;;:"_' "! ' SPECIFICALLY LISTED BELOW.
;. °'D . :Gu'•. i 1 LAWS MUST EE COMPLIED
A!!'' f. ; P' c tore D,te
• WITH NO VARIANCF' ❑ WITH
NO OTHER DEVIATIO':S FR: :.; T :'::
ORDINANCES WILL BE PE''1i t':':
ALL OTHER APP! IC A8'.E STATE
WITH BY ALL PARTIES.
FIRE DEPART .1Eii,
PUBLIC WORKS
POLICE DEPART:.IE-
+_ e
BUILDING DIR= :;TO.: / �
PLANi;ING & ZJiti....
VILLAGE COU;;':I!.
APPROVAL
PRELIMINARY: FINAL:
REMARKS:
i
COMPLIANCE WITH - 1.' 4 E SOUTH i ' ...; ' . • '. l'19: .t; f :1E AS ADOPTED
BY MIAMI SHORES VI' !:s:r 1- :: - ':'! - . E ;+ ;'r+E'T. BUPP.DER
SUB CONTRACTOR'S
ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED
.
&
HEREIN.