230 NE 102 St (5)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date (' I " l Job Address 23 0 ME 1 U 2 S Tre e Tax Folio
Legal Description A ` A C• Historically Designated: Yes /N`o
Owner/Lessee / Tenant 'Pa' v v t &{ l i Master Permit # `�' 7 ' S 7
Owner's Address LO OE (01 'S r Ail ` (AV V 1 1 Phone - 76 q - (pl � 1- t
Contracting Co. C X /' CK Address V `� 4 1 ` � 1 3 2 F)
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BBUILDING ELECT ELECTRICAL PLUMBING " MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Dvc d V l 0 lASe C V 1o1M 1 h AS G (7064".5
Square Ft.
8 X \ 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.
0 IDAVIT: that all the foregoing information is accurate an all work wil . - one in compliance with all applicable
laws - :i . ting construc d zoning. Furthermore, I authorize the above -nam • • actor to do . - •rk stated.
FEES: PERMIT L 7 RADON
/ - / 2
ignature of owner d/or Con • ' resident Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
APPROVED:
Zoning Building
Mechanical Plumbing
5
C.C.F. • 4
Estimated Cost (value)
14,00 ° °
ature of Contrac or Owner -Bu' Date
0 -?P)
Notary as to Co tractor or Owner - Builder
My Commifsi
(-mil 6 0c-
Pig Pr
NOTARY
II us. OFFICIAL NOTARY SEAL
FSXAR¢AR 61ONTIEL
Electrical
Date
BOND
TOTAL DUE V5 �
Engineering
f -ro , o � k
3
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8
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Not valid unless embossed
with Surveyor's Seal.
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PROPERTY OF: Mc s oiolin C. and Pauli
A BOUNDARY . SURVEY
1 hereby certify that the survey repre-
sented hereon meets the minimum
technical standards set forth by the
Board of Land Surveyors pursuant to
Section 472.027, Fla. Statutes. There are
no eperbach ts,Overlaps.easensents
• a thecPlatio •r than as
0.
r
fla. Reg. Land Surveyor No M
1;4 444 ct.ofit
simmom
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Not
etieroaell-
1A.:tits ould
t ics, it any,
.iot i °called .
230 N.E. 102nd %I
r•P ir %id 64 INC.
ENGINEERS - LAND SURVEYORS - LAND PLANNERS
Office address: 359 Alma( Avenue. Coral Gebles. Florida 33134
Mailing address: P.O. Box 561131, Miami, Florida 33156
DATE SCALE DBAWN IDRWG. NO
7-24- t pf.20 191-7434