318 NE 102 St (5)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date a / 3} 1 Job Address (D /UF 1 O S f Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant C (A IP t;s J— /N14...,f 1146
(,fi 4) u ` ) CA it Master Permit # t /<' 9' ( )
Owner's A d d r e s s 3 17 / v £ 1 0 )-S' ' P h o n e 5 S E — 1962a1
Contracting Co. (/ cA.),— Address
Qualifier SS# Phone
State # Municipal # Ins. Co.
Architect/Engineer
Bonding Company Ufa ss
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBINGG MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION e,i0a4t-rk ,L- fLJ / yi e4-`t9.1
Square Ft Estimated Cost (value)
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 OF 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.
z / ??
Signature of owner and/or Condo President Date
ecmicma ("Am c )/3/92
Notary as to Owner and/or CQUd6 Prctiflent Date Notary as to Contractor or Owner- Builder Date
My Commission Expires:
My Commission Expires:
FEES: PERMIT
APPROVED:
Zoning
Mechanical
SPRY PU OFFICIAL NOTARY SEAL
O. <i BARBARA ANN FUCAZZI
z> 4, COMMISSION NUMBER
`t .''' CC360191
7 T F MY COMMISSION EXP.
OF F c:a pqri
RADON
C.C.F.
Address
Signature of Contractor or Owner- Builder Date
NOTARY
I ?ad
BOND
TOTAL DUE 4 Kir✓
Building (` Electrical
Plumbing Engineering
PAID BY
W
W
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
—erSZ-tat
1940
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1941 •
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1943
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1949
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1950
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LOCATION 1 318 N. E. 1021 d Street /0 + h71( 9- ` ja 3 .S',GARBAGE TAX RECORD
33.8 N. E. 1023x1 St.
by
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• C
year annual • tax _periodused__ _._amotint_paid
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