390 NE 102 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date q - ) WJob Address 90 NE 10.) S-" Tax Folio //- 01 3 - T716.
Legal Description Lg +1 / a - )K 3
Owner / Lessee / Tenant V i v ic.-- )0-0 dp-i �,. Master Permit # 3657,
Owner's Address - 3 1 O A e - C v a-- 3-4--- Phone -7 3 (P- I-S°
Contracting Co. nt■-04 Address 340 P -l-- 4v -a._ CI
Qualifier1ok,"ej+ ZS - K. _cam SS4# Phone l ?
State /iJ0 # Competency # Ins.Co.
Architect /Engineer
Bonding Company
Mortgagor
Address
Address
Address
Permit Type(circle one): BBUILDI ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION .mss ,Q Qx�. - yv , �C�
,5 Jr
Square Ft. Estimated Cost(value)
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
be done in compliance with all applicable laws regulating constr
authorize the above -named contractor to do the work stated.
%SR Q (1 1%40 Ja
Signature of owner and /or Condo President
Date:
APPROVED:
cu ate and
dz,on
** * * * * * * * * * * * * * * **
PEES: PERMIT 5 RADON C.C.F. ►10 NOTARY TOTAL DUE 30`
Signature of Contractor or Owner- Builder
•,;";• D ®RA K. LADD
NOTARY PUBLU
Ati ' A T E OFF 0
Notary as to Owner and /or Condo President ° •; � . C r , o a t . ;. , actor o (Xwne Builder
My Commission Expires: " ' M y g ?4 A g , ' fi res:
Fire Other
Zoning Building Electrical `1
Mechanical Plumbing Engineering
all work will
rthermore, I
4i*"?
PERMIT AYYLIC,A L IU r
Date ' I R -q1 Job Address
310 A1E" i°„\ St Tax Folio /1 3'-06- of 3 -S7 v
Legal Description
� i view 12 u- c L Master Permit p
Owner / Lessee /Tenant � ly
et a /u 6 (b S -�— Phone 1 S 1 --`9 O
Owner Address •
Contracting Co > �` _ '
Address 3 14, u o,�K — DI v d
qualifier
o d SS# - Phone 6 ? - 7 0 0 3 dv
State ii 0/30a14I Municipal 0 _ Competency f Ins.Co.
Architect /Engineer N--6L_ Address
Bonding Company
Mortgagor Address
Permit Type(circle one): BUILDI ELECTR CALJ UMBING MECHANICAL ROOPING PAVING FENCE SIGN
WORK DESCR I PT ION /
e- Vie e_C —
S'
Square Pt. 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 (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, ROOPING and MECHANICAL ORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information a c rate and tha all work will
be do - in - ompliance with all applicable laws regulating cons t and on _. furthermore, I
auth•�1
= •- above-named con actor o do the work stated.
Signature of o •= and or Condo President Signature of Contractor or Owner Builder
Date EtictseCk K. LADD
NOTARY PUBLI
STATE OF Fl
fRa
COAL. d1C gg3 ¢ractor o er= Builder
MY 1Cpires:
DEBRA K. LAD' , •
94 eF PlEt ' ' ACond° P i • ent
VppBR* $4e 07183698
My Comm. Expires May 5, 1997
Address _
** * * * * * * * * * * * * * * * **
PEES: PERMIT RADON C.C.F. NOTARY TOTAL DiJN
APPROVED: Fire Other
Zoning Building Electrical
Mechanical Plumbing Engineering
** TOTAL PAGE .004 **