FENCEDate Job Address SO XJ /0/ . 7-- ax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant Master Permit # 3 7,5
Owner's Address 5 10 ,le / 0) 34
Contracting Co.
Qualifier SS#
State # Municipal # Competency # Ins. Co.
Address
Architect/Engineer
Bonding Company
Mortgagor Address
c- -
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING ENC SIGN
WORK DESCRIPTION CLC `( / C ? ?i: - JJ. S't / U on dial
Square Ft. Estimated Cost (value) Ti
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 perfo ed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
permits are required for ELECTRI
OWNER'S AFFIDAVIT: I ce
laws regul : ; g constructio
Notary as to Owner and/or Condo Presi , nt Date
My Comm .ssjglaApires �
C C � IAL NOTARY SEAL
. .1 31 DRA M MONTIEL
s P 2c t l • •
CT N 1 UMBER
c r -,4 n MY COMMISSION .EXP.
nF F` 09-
AUG. 17 1998
FEES: PERMIT 3 c o RADON
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
APPROVED:
Zoning Building
Mechanical
t all the foregoing information is accurate and that all work will be done in compliance with all applicable
g. Furthermore, I authorize the above -named contractor to do the work stated.
_1"
e
- 22. -°r,1
Address
C.C.F. NOTARY -
Signature of Contractor or Owner- Builder Date
Notary as to Contractor or Owner- Builder
My Commission Expires:
Phone
Plumbing
Electrical
is -75`93
/ 774f s
Phone
Date
TOTAL DUE ) S
Engineering
- BOUNDARY SJRVEY
F. I.P¢ %2
F, LP
P.
I o 1 A S P i..! A LT L-
ov
0 0 E . ST-f. .
4 5 I,
pri
p
11.1' l'1 � r 1
2a ' Pa r E,01J
. 2
PGl%J Cl/
u �'
NOTES:
2EARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE
- ELEVATIONS WHEN SHOWN ARE REFERRED TO
1 " - 1 .
c , .L'
4.6
•
o O
0 .0
1' . ��..
SCALE: 1" = 20'
X 90
i ' t a 1 F1.1- ds %n F
10 cT
.0 •