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435 NE 101 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date c) I b '" Job Address L i 35 lV /01 Si- Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant -c! 1 (l 1 I c ` b 7 Master Permit # 4'o g V Owner's Address q`35 I J E- 10 1 S+ MS "5 Ph 1 7 5 I " w 7 Sb'' 7 )./ Contracting Co. © W h QJ. Address Qualifier SS# Phone State # Municipal # Competency 1 Architect/Engineer Address _ Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION �SH VU - r -1-100s e " e 4 73-1---- Square Ft. Estimated Cost (value) r pl, 0 0 0 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. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable la . : lating construction and zoning. Furthermore, I authorize the abo ed contractor to do the work stated. a • • Notary as to Owner and/or Condo President Date My Commission Expires: APPROVED: Zoning Mechanical C f owner and/or Condo Pre Date FEES: PERMIT 47/C) RADON Btoding 44- )1 ( P of Contractor or Owner- Builder Jjbfrin Date My Co Notary as to Contractor_ or OwnerBuilder= Date mmifsionAxgir l Vti'tAVIV 0;:�� 0v e s'Ai 9na Ca EanTiG6 p2 -/ 0— y Girl CO;_: itoc= •n�5'�. a n qq) C. C.F. r °i' NOTARY ,S' . BOND TOTAL DUE a6 Electrical Plumbing Engineering