334 NE 102 St (9)Date 7/9 / Job Address ,3 ,$ y /I/.0 , / p 1 $T . Tax Folio
Legal Description Historically Designated: Yes No
(
Master Permit # ` e
Owner's Address 3 9 Y A f• /02 5 i•
Contracting Co. / 2 G C3 a / 5 t u w .Ter C G. - v C-
Qualifier L l : O B i vt. S SS# 3s _3 y —5.9 y7 Phone 7S —fit;
State #
Archite pneei) � .. /l; • S Gi c i in. Z; C► 447 4 S - s n c Address / ` g o S 1.1.)• 7 .9„ C /12 /44+/
Bonding Company Address
Mortgagor Address
Permit Type (circle on ye.` B UILD ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 6, rt, 1 1 -2- - et - A,4 , f—' 7c) / !'d'Ac 09.3- I. 6 tg C tttkt. (4 c i
77t //4-1, K►Ke ' AC-4 44 1- I,vSr/!C G.e1g tZc'
Square Ft. Estimated Cost (value) .6 / c c e , o
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.
OWNERS 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.
Signature of owner and/or Cdndo President
i ♦i� �.Cl' C.\ \\ ,tip \1O\�)
ot ` lido 1
Notary,as to Own:.r and/or Cdtid'TPfeSident
NIy- Commission'Ex:Pires: - :, t
APPROVED:
Zoning
Mechanical
PERMIT APPLICATION FOR MIAMI S ORES VILLAGE
Cl 6 6 . 6/6. S /, e
/ Tenant 47 /1 s fl/1/t S t P
Municipal # Competency # / g 3 B 7 Ins. Co.
Building
Date
ate
FEES: PERMIT 202. RADON 2 • Z 0 C.C.F. f 1.40 NOTARY
Phone 7 5 — 7g ! 3
Address 6 7n / A /.C- 3 , g vC / /,h /4" /
Signature ontracTo r Owner-Builder
� PV ( Maria S. fto& i u:Z
No ary Pubic, Stctc of Florida '
: s- ir.allo. 2-69
Notary as to Contract r or O r- ` ueTC ` ° ei ,
1.80.1- 3-,t ^'"' 71x';. "v� E7 BC ie
«(((((('"< :. uccuu<<a crutaltc: r t<cll
My Commission Expires:
Electrical
eowO : 300
TOTAL DUE .402 I` .S5
Bow 300.00
5 I 6. Ss
Plumbing Engineering