ALARMPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 1 1/24/99 Job Address 1350 N. E. 101 St. Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant STEVEN & JO JACOBSON Master Permit # Gf s? 3'
Owner's Address 1350 N. E. 101 St.
ContractingCo. SECURITY MASTERS,
Qualifier RON ADAMS SS# Phone 305 8 9 3 - 7 7 6 6
State # EGO 000104 Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Notary as to • r d/or Condo . -'
My Commission ' xpires:
FEES: PERMIT and RADON
APPROVED:
Zoning
Mechanical
d/or Condo President
INC.
BURGLAR ALARM SYSTEM
1 CONTROL / 26 ALARM POINTS
Square Ft. Estimated Cost (value) $1,100.00
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.
Date
tune oti(twner
v I
I '
Date
q
NANCY GOLDRING
NO rARY PUBLIC STATE OF
OOMMISION NO. CC61657
•
gnature ot'tontractor or
Notary as ntractor or Owner - Builder
My Commissipn ir xpires:
4� ry -�. Luz Albaran
_.: MY COMMISSION # CC703192 EXPIRES
December 16, 2001
BONDED THRU TROY FAIN INSURANCE INC
V
C.C.F. / • NOTARY
Building
Phone 305 757 -9334
Address 1150 N.E. 125th Street
//
Electrical
//Nell
BOND
TOTAL DUE O
Plumbing Structural Engineer