585 NE 102 St (3)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date5W / i tbS Address�5 ( r 1. 1 , ` S . Tax Folio // — O G - p / °? - l o / o
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Legal DescriptionSiEc ( 2.3 2_4 x ? 3 Historically Designated: Yes No
Owner/Lessee / Tenant \ % 1./\ .
Owner's Address s 0 /G a Phone 7s 7 clz
Contracting Co. 0 W Q f- Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION C- 1A. ./Mbe--04G/`t`
Square Ft. 1 n y (� /tQ.sJ `^" Estimated Cost (value) 1 n7 0 0
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 • Main a •erm t work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be perfo e standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRI AL P� : ���:ING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVI
laws regulating cons
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Signature of owner and/ r Condo Pres� dent at
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Notary as to Own
My Commission E
FEES: PERMIT •0. 0 0 RADON
Master Permit #
regoing information is accurate and that all work will be done in compliance with all applicable
ore, I authorize the above -named contractor to do the work stated.
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Signature of Contractor or Owner - Builder Date
/ / /f c
nt • Date Notary as to Contractor or Owner- Builder Date
My Commission Expires:
i'F'r'ICIAL� NOTARY SEAL
O �- SCOTT W DAVIS
"" a ;t0 >" COMMISSION NUMBER
` L ' CC255237
ale w�if�' <�' MY COMMISSION EXP.
e 0r "'•�` JAN. 26 1997
C.C.F. . NOTARY ..i o TOTAL DUE' k.ra
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
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For: Berkell, Strauss Er Benjamin, Attys.
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LOT 24
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This property described as:
The East z of Lot 23 and all of Lot 24,
Block 93, MIAMI SHORES SECTION No. 4,
according to the Plat thereof,
as recorded in Plat Book 15,
Page 14 of the Public Records
of Dade County, Florida.
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For: Berkell, Strauss & Benjamin, Attys.
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LOT 24
This property described as:
The East of Lot 23 and all of Lot 24,
Block 93, MIAMI SHORES SECTION No. 4,
according to the Plat thereof,
as recorded in Plat Book 15,
Page 14 of the Public Records
of Dade County, Florida.
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