890 NE 100 St (12)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
9 Job Address h9® / v 2.2• ) C2 r Tax Folio
Legal Description
Master Permit # 6
/ Lessee / Tenant F Hi l e,_
Owner's Address g 90 / V • ) OO
Contracting Co. Address a/ N. g . M i l 0
Phone 7 -/q
A / ,33/6.2
Qualifier Fii9/V�S� �s� Phone 94/7-50'd
Star fk (7 °° 74 Municipal # Competency # Ins .Co. // -�%
Architect /Engineer Address
Bonding Company Address
• Mortgagor Address
Permit Type(circle one
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, ROOPING 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 constructio =nd z• ing. Furthermore, I
authorize the above -named contractor to do the work stated.
askar %V si dent
�`+v IV
S
STATE OF FLORIDA
My Comm Exp7/31/95
o ary as to Owner and P or ON�?ED ondo President
My Commission Expires:
** *
APPROVED:
* * *
: BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
* *
FEES: PERMIT IliP
RADON
*
i 1
i
Fire
Zoning Building
Mechanical dsY I1Plumbing
* * * * * * * * **
C.C.F. %;6 NOTARY TOTAL DUE 7f `
Jl Z,-,zj
Signa •►.e of Contr: •r or Owner- Builder
Date: / '41 , 1'EILA DONOVAN
M TCorn OF FLORIDA 5
o y as to ontractfileNBEDDwner- Builder
My Commission Expires:
Other
Electrical
Engineering
NOTICE OF COMMENCEMENT
PERMIT NO. TAX FOLIO NO. // 3 Z C Co 0
STATE OF FLORIDA:
COUNTY OF DADE: ; J. 4.4. 1994 JUN 23 09:27
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property. and in accordance with
Chapter 713, Florida Statutes. the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: HI 4 k 1 S 4 S 3 L 6 170; / v- 3
Ct; t l z LL 4 s //6
2. Description of improvement:
3. Owner(s) name and address: f-h' ?' / .j ‘ E Lir L S 4
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: 7 C. , /47- P /.4 / /T L
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designat
by Section 713.13(1 Florida Statutes.
Name and address:
8. In addition to himself „Owner designates th
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
2v 3 / � / s, 1-i r ,hti
/ 1? i :T p I Qk2
Sworn to and subscribed before me this 1 day of ----flt,f 4 . 19
Print Owners Name
Notary Public
Print Notary's Name
My Commission Expires:
SHEILA DONOVAN
Public
.Z» s ,- Loh �- F I C-E7.0 fr —/”
My Comm Exp7 /31/95
BONDED
on whom notices or other documents may be served as provided
STATE OF FLORIDA, COUNTY OF OABE
1 HEREBY CERTIFY Ma' this is o Iruo cops, of fho
original filmed • .'s o+nc, on Z 3 dov od
Wkrovided in
Prepared by:
Address:
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