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ALARMS
Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE � A CC-3-99 Job Address 1I v ` 7. G . rt9/ Tax Folio / /' ��"0 9&8 (via Legal Description 1 7.7,1k 1 G®r©h Sh (91'v S Historically Designated: Yes No Owner/Lessee / Tenant ) P) 1 a ri 0 Owner's Address ion #' t&/ 44'4 ;veS Contracting Co. 4Dr SerV / CL°C 1C3z SOC.c %4Wed/ Qualifier kliejno Ie Book re, SS# - Phone SO — 6 / - 7 State # ( © Municipal # Competency # Ins. Co. Address azure of owner and/or Condo President Notary as to Owner My Commission Exp FEES: PERMIT 3S ' OO RADON DL. #,0 23 - S' TAYt+S CCII1MISSION NO. CC751531 COMMISSION EXP. i1;':" I5 2002• to/ 117 2. dd v/res /7J/99 Date 0 Address Architect/Engineer Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION � tru l' ro? ,SJc "' rr' Square Ft. Estimated Cost (value) 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, eg}ilating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of Contractor or Owner -B il Notary as to Contr My Commission C.C.F. 1 (0 0 NOTARY Master Permit # APPROVED: Zoning Building Electrical Mechanical Plumbing Engineering Q �fS',- c /a Phone S 757 / 9'JpA TOTAL DUE F Date ate ,() 442i,yp