254 NE 101 St (9)Date
Qualifier
State # f FOoGO 6 L3
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDIN
WORK DESCRIPTION
Square Ft.
gnature of owner and/or Co do President
Notary as to Owner an
My Commission Expir
APPROVED:
Zoning
Mechanical
bob o9
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
1- / Job Address 0259 //JC ID/ 3 Tax Folio
Legal Description
Owner/Lessee / Tenant
Owner's Address c it /0/ S
Contracting Co. pt /f?
Municipal # Compete
Address
Address
Condo President Date
ASQUITH ROY TYSON
NOTARY PUBLIC - STATE OF FLORIDA
COMMISSION N CC864146
EXPIRES 8/2412003
BONDED THRU ASA 1- 888- NOTARYI
cle.vLCea
FEES: PERMIT AT RADON C.C.F. . 6 0 NOTARY — D --
Building Electrical
// —30206 0/3 V6.20
Historically Designated: Yes No
mail Master Permit # 7 / ��3
1
%922Z&/kO dress 7-195-9 S9 /v W 5319
ss# Phone 573-03
Address
cY
Ins. Co.
ELECTRIC PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Estimated Cost (value)
Notary as to Con
My Commission
ql /AO—
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.
: I certify that all the fore g information is accurate and that all work will be done in compliance with all applicable laws regulatin€
g. Furthermore, auth ' e the above -named contractor to do the work stated.
9
1 tall./15V/1
Si of Contractor or Owner-B • der
'° v ., •. ELIZABETH GARCIA
• Sr: MY COMMISSION # CC 816633
IInJ
• %� 'r EXPIRES: March 11, 2003
' vcri Bonded Thru Notary Public Undenvritera
BOND
TOTAL DUE SO
Date
Date
Plumbing Structural Engineer