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848 NE 100 St (5)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date :7 f ��g& Job Address pa,* 70e7 Tax Folio Legal Description 5 %Ad t ,6/4/1. I Historically Designated: Yes No vv � r/Lessee / Tenant /v i V ' J ' . ciGL'/ /9,S° Se� � R Master Permit # 3 q' k f 7 3 >\/' / 7 Owner's Address Contracting Co. Qualifier SS# State # Municipal # _ Competency # Architect/Engineer Bonding Company t i Mortgagor 5k I Permit Type (circle one): WORK DESCRIPTION Square Ft. Estimated Cost (value) .1 sow. 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. Signature of owi Vand/or Condo President Date Signature of Contractor or Owner- Builder Date APPROVED: Zoning Mechanical My C mmis Empires: —_ -: <-_ - -__ _ -_ _ _....... �P !/® OFFICIE.,L. idt :, ;,; :s. r r co r;,r»: h:: «< :�:.L.a � g CC4�; .,9 vfF ,W' C; fl V C' ._ „d , :... o 0_0 l'r,,, ti v,, FEES: PERMIT 6 /(/ • RADON Address N ' c v / ca ,1 ELECTRICAL PLUMBING MECHANIC PAVING FENCE SIGN 1 si( /--t a otary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date My Commission Expires: C.C.F. c - V NOTARY TOTAL DUE 44 -) -) � Address Phone 75 Electrical Phone Ins. Co. Plumbing Engineering Legal Description Owner / Lessee / Tenant V J. �( 'f • 1/} ��` > /� i �/f°• Owner's Address gqg `V • � • /00 Sf • a 1.4d/1/1/ A . / ��� Contracting Co. cl 9 ifii ir:e i ti''.P1rI1i..TJ► r' . Qualifier SS# - - Phone State # Municipal # Competency #. Ins.Co. Architect /Engineer N / // g Bonding Company N /4' Address Mortgagor 73q [G TT 4-44Nir Permit Type(circle one): �BUILDINNG ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN / 3 WORK DESCRIPTION 2 fA/) fj/' 4 A6(JZ �` t c �'F,��� r , r /NG4 T i t9F g & A� 1��r,4 /c 7-?- �% / 20,c - ?, %) Square Ft. / 00 Estimated Cost(value) 7d 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 gut o iz the above -named contractor to do the work state . ignature o Date: Notary as to Owner and /or Condo President My Commission Expires: ** * * * * * * * * FEES: PERMIT ■ RADON C.C.F. Fire APPROVED: Zonin PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Ad ress2 er and /or Condo President Tax Folio// :Z06 it X030 0- Address Address Signature /9,4, Date :• iii i'tar as to o �,,.'i� y Commission E p3•�:�a; * * NOTARY 8 0 Master Permit Phone 757',560.5 -1a1�4 or Owner - Builder bb C©WITeVAIII4IKOr No. CC197545 TOTAL DUE 45/90 * * Other Buildin Electrical Mechanical Plumbing Engineering • :,,,,,,...,:su„.,.. ,...,...,rg.,,,.........,„....,,,,....,3.,.....„...„,..,c. •••,...., ,,,,,_ • •