150 NE 102 St (2)Owner's
** *
APPROVED:
Date
Legal Description
Owner / Lessee
WARNING TO OWNER: YO
SO MAY RESULT IN YOUR
TO OBTAIN FINANCING,
NOTICE OF COMMENCEME1
i
i
y Commission Expires:
tary as to Owner and
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Zoning
Job Address IJ O (OE . 1 0,2i
/ Tenan
Square Ft. w9I.
'Viral
9-1 9 / g„eee
Address /3-0 �i= •I0 -Sy�; //
0, 1J'�{ -la-o
i
1 � 11 t a t n Phonew - ,, � q `( l -q f OO
Contracting Co. .r5 d4-(.k a AA, S YrofeSS; op.) t L Z:at.. as (Kit. Address c 411 (2„iet /�'I: r4Ml, ti= 4. , 33 o.1s
Qualifier Phone 3 os Y3'? - o? 71x1
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one : BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCR'(TION '. J t r oo+ 0UC e)r *La. riot-
s
Application is hereby made to obtain a permit to do worx ana 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 abov - amed contractor to do the work stated.
l c� . ►" n 1 . r a/� 0/4
Signatur of er and /or o esident `
• Date: /, ,
' JOSEPHINE CHUM
:•otar P
.•• Na CCIf7l1I
31g
PEES: PERMIT 1 7/ 5" RADON C.C.F. c.0
O Pou
Signatu of tractor or Owner- Builder
Date: /
tary as to Co
y Commission E p
.�1/0; ,.
Fire
: uildi - 2.c) -
Mechanical Plumbing
Tax Folio 11 J 6/I /r2/"
e)
Master Permit #1 d
:NT AND YOUR FAILURE TO DO
JR PROPERTY (IF YOU INTEND
tNEY BEFORE RECORDING YOUR
1!h!
q t 00
':,t. JOSEPHINE CINAEN
. _?►ir .1r7. n 7,
_ a,
a
Na CC19754
* *
NOTARY 3 TOTAL DUE 44 0/
Other
Electrical
Engineering
. #
•
PERMIT APPLICATION. FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date f
1 /
j r L 2 2 4
' �� J ob Address � � e � C . D �/ � Tax Folio
//
Legal Description 107` /��I I1 4J.J . fez / /P,,)
Owner / Lessee / Tenant C4 4(5/ P n ) L'i Czt Master Permit 1) ✓
Owner's Address , c 1 C 4 ST Phone ? i ° 7
Contracting Co. G 511 'f/ Address
Qualifier - - Phone
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIG/
WORK DESCRIPTION � 7 ' c(/ S
Square Ft. Estimated Cost(value)
TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DC
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENL
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUF
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, an
on the attached addendum (if applicable). I certify that all work will be performed to meet th
standards of all laws regulating construction in this jurisdiction. I understand that separatf
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 wil.
be done in compliance with all applicable laws regulating construction and zoning. Furthermore,
authorize the above -named contractor to do the work state
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
Owner - Builder
fibinrc-of art egy.Pub is
Personally known O o uce T.D. Notar Public Slat. 0f FlOi;d'
Ty )e and number of I.D. produced: p,�y Commission Expires 9/18/`
* 5 ___tl?a- �_ �`{ * Bondgd Thru SWcnblw,s ditus it E
** * * * * * * * *
take an oath, or an oath.
13 RA DON C.C.F.
DID NOTARY 00 5.x®0
FEES: PERMIT TOTAL DUE
Signature
Dat
S Zj 44.1c1
Owner- Builder
APPROVED: Fire Other
Zoning Building 41 11 Electrical
Mechanical Plumbing Engineering