553 NE 101 St (11)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date it r ` Job Address .S 3 �. 4 lO f 57' Tax Folio
Legal Description Historically Designated: Yes No /
Master Permit # / 2 `7 2-7—
Owner/Lessee / Tenant r4 t esz .% ria,v
Owner's Address S�? N. l . l a / S T Phone 7SS .- 4 7'-! �1
Contracting Co. W/ E ae-
Qualifier SS# Phone
State # Municipal # Competency # Tnc C
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT VC • RADON
APPROVED:
Zoning Building
Mechanical
Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
■
WORK DESCRIPTION (/4 / /V I // () e-(- _
Square Ft. Estimated Cost (value) C` oC . 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.
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.
f �y- 5— /
and/or Condo President ate Si ui er
Signature of owner and/ Signature of Contractor o er-
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
�p.RY PUd OFFICIAL NOTARY SEAL
O l� SANDRA M MONTIEL
tl .� COMMISSION M
��;�� 1..* CC401 BER
1
? ,,. Q
. . _ .... COMMISSION .EXP.
TOTAL DUE V 8--- 66
Electrical
X
Date
Plumbing Engineering
A.
PF PPLICATION FOR MUNICIPALITIES OF DADE COUNTY
Job Address 5 A)6 /0/S Tax Folio, 7 g 0 6 / f /gD
Legal Descript j .,4 /9 9' 'r Master Permit #
Owner / Lessee / Tenant leeyG SoLc1 7 " �jvi 411r9 T� S
Owner's Address
Contracting Co.
Qualifier
State#
Square Ft.
(OWNER TO RETAIN COPY)
Address
SSA - - phone
Competency# Ins. Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
phone - 7 .-5 c J 2
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION yy ' 4 « '• 7 / -' S
Estimated Cost e
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. 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.
Sign -ture o Owner and /or Condo President
Date:
a - f5/
Notary as to Owner and
My Commission Expires:
*
dPat alife@ltFLORIDA Notary as to Contractor or Owner - Builder
Y COMMISSION EXPIRES APRIL I6, ]992 My Commission Expires:
BONDF*FHRU STEME*R -ADAMS & WET * * * * * * 1k
PERMIT FEE: APPROVED:
,Ig Zoning tealdi 1 '9 '
SV Mechanical Plumbing
ii 3 , 00
Fire
Signature of Contractor or Owner- Builder
Date:
Other
Electrical
Engineering