802 NE 100 St (9)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
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Legal Description s., Or /1 /4 t S 1 »L v Historically Designated: Y
S��rS
/ Tenant W/ I- L / R h
Master Permit #
No
Phone 305 75$ 1)27 a
Owner's Address
Contracting Co. OW A7 j; R Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
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PRM S D a Lot ha T+? C - A T 1 = n ,e g A) e F lit /DUD R a A 1 S �J' � j
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Square Ft. Estimated Cost (value) t�d
WORK DESCRIPTION
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.
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Signature of owner and/or Condo President Date Signature of Contractor or Owner - Builder Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
RADON
C.C.F. — NOTARY
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
APPROVED: C�
Zoning Building Or f Electrical
Mechanical Plumbing Engineering
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7X4 P.T. WOOD RAILS
TEPYCAL (.W 3
IX6 r T. W000 PJCXETs
(DCG EARED)
4X4 P.T. WOOD POST
?5'-0' QC. MAX
SLOPE TO GRADE
3000 PS; CONC R3O sNC
Fence Detail 3/4"