429 NE 102 St (3)Date
Legal
Owner / Lessee / Tenant ( i(1M ( -S L `I WCH Master Permit # `1
'
Owner's Address 76.9 N1E I O� S� M , .nc, ") Phone
Contractin Co. q `c I_ rt4L\ c1„.,n 03o, I6l0 Address 4 CAC) W I la y P N
Qualifier et Q Prkb QL SS# - - : Phone O S ( L/9
cote ,
State # #(,(v7 iO7 Municipal # Competency # Ins.Co.(16u1,41 .P11.t 10 eO
Date.
APPROVED:
Description
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
of owner and
Job Address LA 9.9 NE (rah Sr Tax Folio // off /7 4
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION R 0F) kK)citle lAJCO lA 1n CL
Square Ft. Estimated Cost(value) kC 'l.
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.
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 an. zon'ng. Furthe 1u.re, I
aut 4 ze the ab • , e • •,. tr or to do the work state
Condo President
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * * * * * * *
FEES: PERMIT RADON C.C.F. 1 ` NOTARY
Fire
Zoning Buildin
•
Notary a
My Commi
Owner- Builder
p11Y l'u 0 ~l POTARY SEAL
►�� poctifFactssrromr emer -B iilder
p JMMISSION NUMBER
,,,... CC255237
7 rF :
" " MY COMMISSION EXP.
Op ,IAN. , 26 199"- 7
TOTAL DUE )1
Other
Electrical
Mechanical Plumbing Engineering
sq PS vI ALIC,
RE
rIZOFtroW WALK
6
-- 4Zi NE 10/ s
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•
•
VIZOIX.P.47 _
VIA 6;1 .
THESE PLANS ARE APPROVED FOR
ISSUANCE OF A BUILDING PERMIT
VARIANCE(S) LISTED IN "REMARKS" AND
MIAMI SHORES
UNLESS SP CIFIICALLY LISTED
AND COUNTY LAWS MUST BE COMPLIED
Auth'orind Signature
ZONING
BELOW,
Date
• WITH NO VARIANCES • WITH
NO OTHER "S FM THE
ORDIf ANCES BE PFR ° IT ED,
ALL OTHER APP' ICAB'.E .:'i \TE
WITH BY ALL PARTIES.
..I :E DEPARTMENT
r
,.:j I _ DAP �.R}'1':;:
IIIIIIIIIIIIIIIIIIIIFLAVIIM
___i
NM-
:PALM, iG DIRE'',. 0.
PLAN :1,1G & Z3.:; .. ' ; •
VILLAGE COUWX!
APPROVAL
_...
PRELIMINARY: r F9(ir,ALo
REMARKS:
COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED
BY MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER &
SUB CONTRACTORS ARE CHARGED WITH THE I KNOWLEDGE
NG REGULATIONS WHETHER OR NOT SPECIFICALLY INDICTED HEREIN.