568 NE 102 St (6)Legal Description
Owner / Lessee / Tenant
WORK DESCRIPTION
Notary
My
** * * * *
FEES: PERMIT 4
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address .a�: ' 4 /GJ i-'/ Tax Folio
Owner's Address S , /' a Phone
Contracting Co. 4//1 KJ ` "Y Address 5 /5
Qualifier l)OAG�•.4(J A ss# / Phone 5,( ZZ-
State # Affill ✓ `� r! lunicipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING CTR AL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Wkai
l i d d-41:
)
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 (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 a zoning. F ry ermore, I
authorize the above -named contractor to do the work stated.
M ie r
Expi
LES
n Expires
996
RADON
President
/cr ° •G9NAo 5 rres ident
* * *
Zoning
Mechanical
Sig
Date:
Notary as to C
My Commission
Master Permit # 3,450/
- Builder
s on Expires
no 4, 1996
o. CC 205953
tractor or Owner- Builder
xpires:
* m
C.C.F. NOTARY TOTAL DUE,01GV
Fire Other
Building Electric
Plumbing
Engineering
IIIIBRINKS Brink's.Home Security, Inc. • 5765 N.W. 158th Street • Miami Lakes, FL 33014
HOME SECURITY
To whom it may concern:
Please be advised that the following permit should be
cancelled:
Thank you for your cooperation to this matter. If you
should have any questions please call our office at (305)
558-66 5.
4?e4.1,,,, *5sf
Very ru,y yours,
i
Qualifier
License No EF0000873
WITNESS my hand an seal
this /a of
Notary �y>!l513c
My Com kocerAl
1 JULIO EMBLEM
PJ COF71mIsoIor1 Exp!roo
Juno 4, 1996
►:? °' Comm. No. CC 206953
Permit No. 3g6
Customer: J1/1
6.ailiotkok.
Address: 568 41€ /4
, 199,e
JULIO ROBLES
MY COMMISSION k CC 550034
EXPIRES: June 4, 2000
A . Boned Thni Notary Pub c Undmwdt n
Affordable protection. A name you can trust`"'
305.558.6625