432 NE 100 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 8- i0-7({ Job Address 43. N /06 .St Tax Folio //-3.).06-6/7 3 - 76
Legal Description l- o t 7 /ff T3 //f q n(-4 `. ' .
Owner / Lessee / Tenant CI EL ocq - Master Permit # :3
Owner's Address 3 /v o • Phone 7- ' l33.3
Contracting Co. _, -q J./ e---/ Address 37/o fC --€4 Q
Qualifier . Z SS# - Phone C --7 c).:?
State # EovablC((Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDIN ECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION - 13114Lx —
(� c! e.l �cts — J'
Square Ft. Estimated Cost(value) 4 ' % -
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, ROOPING and MECHANI WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information
be done in compliance with all applicable laws regulating constr
authorize the above -named contractor to do the work stated.
Signature of owner and /or Condo President Signature of Contractor or Owner- Builder
Date: Date:
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * * * * * * 1 5 6 FEES: PERMIT RADON C.C.F.
Mechanical Plumbing_
DEBRA K. LA
accu ate an
n : nd on
?j A. "•f .ti • • :7 t ' or
.r! C • Il iQEikt1:
:;E...... � COMM. NO. CC 283698
My COMM. Expires May 6, 1997
all work will
urthermore, I
r- Builder
**
NOTARY TOTAL DUE 4
APPROVED: Fire Other
Zoning Building Electrical
Engineering
Date:
os
pate
$ o Job Address q 3A N E ) Od L T : 6 - Tax Polio a //- 3 )-06- a/ 7 - ° 3 70
Legal Description 1-- a ix cy fr - :
Owner /. Lessee / Tenant C J e - C���o •---1 Master Permit #
Owner's Address 4 3) Ai E. r °Q 4 e- •
Contracting Co. C ru ....,-� e - v A - vO — 'eS Address 3 790 P.:4< C °- a-
7
Qualifier d" &. Kam- SS#i -- Phone 9
State #k az Municipal #t _ Competency #i . Ins.Co.
Architect /Engineer
Bonding Company
Mortgagor
Permit Type(circle one): BUILDIN
WORK DESCRIPTION
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 W.RK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is c at and tr.-t =1 work will
be done in compliance with all applicable laws regulating construe io• : nd'zo •' 1 ermore, I
auth• the jbove -named contractor to do the work stated. ` /I nfik
APPROVED:
PERMIT AYYLiLrA 11V,^r .: vn jvlir�ivl �.:.::.:.'w• -- - - - - --
or Condo President
9---
Not r, to % w � L£ondo President
I'�'r'' ski y��'L.ORIDA
• .. • 1 .1 COMM. NO. CC 283698
** * ley Come), Expires * ev 5,1 g9*
* *
FEES: PERMIT RADON
Mechc.ni Cal
Address
Address
PLUMBING MECHANICAL ROOPING PAVING FENCE SIGN
• ,
.� �
1
» • , :3
• My Comm. Expires May 5,1 t'?'
Plumbing
Address
e�e.� «mss -
DEBRA K. LADD
Phone S/ - F333
i res:
Engineering
Signature of Contractor or Owner - Builder
Date:
tractor or Owner- Builder
*
C.C.P. NOTARY TOTAL DUE
Fire Other
Building o Electrical
** 1 O 1 =;L t�=