1280 NE 102 St (13)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 7-2 5 / b Job Address l 2 9O 126 /02-.-9 Tax Folio �/ ' .3z 03-- 2 2 'D03 v
J33,3HdfCW% Le-S.5 /ess Su. /Z.�a� -}of
Legal Description a. VS". b0 Iee3 Jul ack J 8S /{,,,e,1 led Historically Designated: Yes No
'I } o1 po, %on5 of req S PA 1 m;•3•.:54"4 Sec; 3 i Phg c `/
Owner/Lessee Tenant De n (se, Wit 541.1. ., G Master Permit #
Owner's Address / 2 /1,. / 0 5i. Phone 71 7 C/ 916 t)
Contracting Co. /V /A Address
Qualifier /U/A SS# Phone
State # /v /4 Municipal # Competency # Ins. Co.
Architect/Engineer /VA Address
Bonding Company 11/A Address
Mortgagor 4///4' Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION m ✓d Se4" 0 P rod) / 9,9--.1-0 (eK s4 ;,) — n 0 /.7cre�Je / n 719-11t) Size
pr- Sl1i4a - M0 r deS'9n. fiA-J�r►� S�dn-eS ,J2-/'/' / J/ : — anticssee 6,ry- .SD,rc49, -c/.19 q ,
�1 � to� r3
Square Ft. � 60 v p Estimated Cost (v ue) '1V9 - '9"h
p w ner olio T ry wdr 1r - 1f4—.-.. 5Q /,,.as
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 rpgulating c struction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
-72.> yd
Signature of owner ndo President Date Signature of Contractor or Owner- Builder Date
Notary as to 0 er
My Commission Expires: _
OFFICIAL NOTARY SEAL
BLANCA BARBARA RODRIGUEZ
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. C418453
MY COMMISSION EXP. NOV. 2,1998
FEES: PERMIT 'lO 0 RADON C.C.F. .Z. 00 NOTARY TOTAL DUE '7ZZ. 00
APPROVED:
Z Building
Mechanical
71114
Notary as to Contractor or Owner- Builder Date
My Commission Expires:
Electrical
Plumbing Engineering
PROPERTY OF: Astor,. Fred, 1260 N . . 102rid Street,:r •;;.4,4*,
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This property .describeeast ',..'•,' '.`:',' '..
. The North 133.30 feet:Ofthe Nest
_ 7 v / c 2 2kfo _ ..rg of Lot • 2,. leSs the South ,12 . 8 0 .,ft
- of , the East 48.60 feet, Block185A
AMEN OED PLAT Or PoRT1N5 OP REVI
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j PLA1 OF MIAMI StiotES SEC: 3-f • — .
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..acdording to the Plat: ..,•-•.*•.''.;
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thereof, as recoide(Vin
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t: • Plat. Book 41 Page- ,6•4 '. •,,, : '.. ,
•of the Public Records. of "
Dade County, Florida.
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Note : Underground enCrOach--,
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.K ments, if ' any,. not'located.'',;"
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4 ' FLOOD 'INFORMATION:
, 1 Community No.: 125098 ' ••••
Panel No.: ' 93
Suffix: F
Date of Firm: 11-4-87
Base Elevation:
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tu To: Home Savings of itmerica
Gulfstream Title Company and Fred
stor.
A: BOUNDARY
SURVEY
t hereby certify that the survey repre-
sented hereon' meets • the minimum
: .‘technical standards • set forth by the
. . : ROitd of Land Surveyors pursuant to
! Set4lon 472.027; Fla. Statutes. There are
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