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1301 NE 100 St (5)Date Legal Description APPROVED: .... • PERMIT APPLICATION FOR MIAMI SHORES VILLAGE r (00 Job Address /301 i(/r x ,c7Zi.7 Tax Polio Lessee / Tenant Jr) t F? Ccrr Owner's Address k36,1 ,(JE M7( Phone Contracting Co. Qualifier SS# one State # Municipal # Com! ns.Co. 00Q Address Architect /Engineer A) tl Bonding Company /1i 4 Mortgagor /(/ A Permit Type(circle WORK DESCRIPTION Pet i f Si_nat o owner and /or Condo President D =te: ,211( /qy Notary as o Owner and /or Condo President My Commission Expo IAL UFFICIAL NOTAR SEA L GLADYS H BARCO NOTARY PUBLIC STATE OF FLORID ** * * * CQMMISSIOIsk NO. 0(*179887 * MY COMMISSION EXP. MAR. 1,1996 FEES: PERMIT 37 one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN �1Cl�e r o r o Sf J1 ou 15 e, ckS 2 r(50 wa 115 *I Boy ,s e a r na fkra/ Br u/S he `eft 4 S ;81 S ©are / ±r ✓n GI-. doors toil/ be_ Fa le d, • ) �� rJ0,,0� Estimated Cost(value) 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 au rize the above- n:w-d contractor to do the work stated. Notary as to Contractor or Owner- Builder My Commission Expires: * * * * * * * * ** RADON C.C.F. - 5Z ) NOTARY TOTAL DUE-Wad Fire Other /I - 320S'/ ' 002O Master Permit # - 9 1 7 7S` 8 -74 31/ ure of Contractor or Owner- Builder /9 � Zoning Building 2 Electrical Mechanical Plumbing Engineering ct