Loading...
1180 NE 100 StPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 1 C d 1 Job Address i ($ O 'Y1 .4 .1 ooS fi Tax Folio Legal Description Historically Designated: Yes No / Tenant i / ¢ H, e 1 A (4..,-S O vt Master Permit # 4(2° Owner's Address 11 So 'YN , - . ton S T ' .4 , 3St Phone .3&- 'Contracting Co. • Address Qualifier SS# Phone State # Municipal # Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 1 wLt h. Square Ft. Estimated Cost (value) G 0 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. FEES: PERMIT Notary as to Owner and/or Condo Pr My Commission Expire -- Signature of owner and/or Condo President /0- ai-9'j sident Date , S PRY Pie OFFICI:tL NOTARY SEAL P � M 7 -- < BARBARA ANN FUGAi. 1 f N q � > COMMISSION NUMBER. CC360191 » � MY COMMISSION EXP. ,; MA n. 29,1990 RADON C.C.F. ID'dte Signature of Contractor or Owner- Builder Date APPROVED: Zoning Building / Electrical Mechanical Plumbing Engineering 7 peteni, fi Address Notary as to Contractor or Owner - Builder Date My Commission Expires: Ins. Co. (2 ....a 7 444.4 &- 4 NOTARY BOND TOTAL DUELO'IO PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date s- 3- q :2, Job Address 1/20 (00 5,1- -T 0:low , Folio �/ ���./ /745/D4 Legal Description �O1 ✓ 4Z, `71' , ' S _CC'('• 1 Owner / Lessee / WORK DESCRIPTION I(C APPROVED: Tenant to 'e N . ( A W C c7 11 Owner's Address I l FSO Yl .£ , ( bo S7 r 7 /.a 144( lt f 5 o k S Contracting Co. Qualifier SS# Phone State # Architect/Engineer Bonding Company Mortgagor Municipal # Competency # Ins.Co. Notary as to Owner and /or Condo President My Commission Expires: Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN t et/ }to-e-z4--t- Master Permit Phone Z0.5 7 Qs-- Address - — Address I ' dress 11 P idress Square Ft. Estimated Cost(value) 1300© , e c 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 construc . Furthermore, I authorize the above -named contractor to do the work state Signature of owner and /or Condo President ignatur o Contractor or • er -:ui •er Date: Date: > 4 JOSEPHINE CHURCH tar as to Co t t� =Y�.T" PtaD rr`'tilaftIA y Commission Erilir 'x1� My Commission Exp. April 311 1996 ••:�or.� No. CC197545 ** * * * * * * * * * * * * * * '' ` ** FEES: PERMIT, f 7/ RADON C . C . F . 1' 6� NOTARY 0 4 TOTAL DUE yII 3' S� Fire Other Zoning Buildin Electrical Mechanical Plumbing Engineering i