1290 NE 101 St (16)Date 3 Job Address /,2-90 (1)6' /0/
Legal Description
Owner / Lessee / Tenant
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Owner's Address /02 90 77 E /0/ 51 ,CARES
Contracting Co..cfi91,//,ai2.Efe /�)e. Address 73S3 7l/Ugd 97r'i, /33/.2
6i 4
Qualifier 2iSies // agx(EN7`E20.5 SS# ¢ Phone ,V6q ao,
State # C i CO/%'Da7Municipal #/85'. F Competency # E- /918 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION S1g77/pe•cJ L'UNGR.E1E DE / V6 w9y &i1-1-k.w6-7/ 4 A
Square Ft. �rP'49-110• / Estimated Cost(value) h ,j D.&
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.
Signature of owner and /or Condo President
Date
APPROVED:
Ceci l)a. u0eicivnek nn
Notary as to Owner and /or Condo esident
My Commission Expires:. MMMRY PUitIC STATE Eir FLORIDA
NY MISSION EXP. M�1Y 15,1994
TE U GENERAL INS. WM.
** * * * •. * * * *
FEES: PERMIT 1 1 1 5 4 1 RADON C.C.F.
Zoning Building
Mechanical Plumbing
Signature o
Date:
Tax Folio / /3aO.O /�/ /0 /
Master Permit #
Phone -. 754/-- 0/y3
Contractor .or_ Owner-Builder
P P P , 1
Notat as to Contractair art r It hk irkil e fe PLORYOj
My Commission Expires ?Y E ` ON EXP. MAY 15 1994
.0 / cI r< R Ng', F11RU gNEML z.K5. UkD,
3 ' P/ NOTARY TOTAL DUE t i I ‘' s�
Fire Other
4 /4 7'
Electrical
Engineering
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Z 9 -
Type Insp'n ' 4i ialie jn
Permit No. B - 03- {S
Na
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee ❑
Compan d` P"
Address
NOTICE OF COMMENCEMENT
PERMIT NO. TAX FOLIO NO. //-- 7, = 9176-0 /4 00 /
STATE OF FLORIDA:
COUNTY OF DADE:
94R 106740 1994 MAR 04 12:35
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: / N 1 / Sf )7 i S77 Re S
( )(7f (kit it /l c? r /,') j . C.) G >< / /
2. Description of improvement: .51/9 '777p4-t, C-0,V CP A. 1"6
p R.0A-al l
3. Owner(s) name and address: y r - \ «. fl' • �_.��C n C, \r■ V"1
. t I t. , 171 (kvY\ \ (•-■ • - I
•
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: , c 1 0 7 1 1 / 9 e/e61 ? / NC
73x3 Ev 9- 7/ - Nri 3 342,6
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1 Florida Statutes,
Name and address:
8. In addition to himself „Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording'unless a
different date is specified)
i !'
Scgnature of Owner
Print Owners Name li ;Y1 • c7 In 0— v1 1-1
Sworn to and subscribed before me this V day of Jv'I / i PCP 19 ? .
Notary Public
Print Notary's Name ,11: / k A /Nits 4' C Ai-;
My Commission Expires: , NOTARY P118CIC STATE or FLORIDA
t ISV Caleiri&ION EXP. MAY 15,1991
WED TNRt1 GENERAL IMS. UH)
4:.
STAT 0; FLORIDA, COUNTY 0 DADE
1 ; iERE W CERT1PY t' o this is a tru cop of fhcr
b t to: in 111 on day¢
,AO 19
W NESS my h r.! ar d Of'iciof Saul.
HAKE. t VIN F K, o ircuif andCourtfyCoUfts
By O.C.
a
/7/J A- -yi
W ALkw4/ >9/V
Prepared by: ( .
Address: ).) 'f\ f U I ST
1 3Y