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ALARMPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 5- 3 - 9(.. Job Address . N L 9 g Legal Description Historically Designated: Yes No Owner/Lessee / Tenant L Y'c, � ✓ o.. o r\ Master Permit # ' 7DS © Owner's Address Contracting Co. Ale, f,A Qualifier 1"1; 2C9 1_ , 2_ e of owner d/or Condo President Dat Notary as to Owner and/or Condo President D My Commission Expires: CO:'r ;.:.FiKo tl !';o. C.C2EC. i,i�y tOivr,11o51:1; J 1:;:1 . APR. 26 1997 FEES: PERMITS. RADON 0 Tax Folio APPROVED: Zoning Building Mechanical Phone Address \ S\ SS# Phone a3s '3 2$ State # a'0060 LQ 1 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING A PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION V ` �� ` ".(\ [, .7)/ wo^- S Square Ft. Estimated Cost (value) 0 CC, 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 OF 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. VNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work '11 . - done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named co ltra k stated. Signature of Contra or or wner- Builder Date .sz 0 - 3 - 1 Notary as to Contractor or Owner - Builder My Commission Expires;_. NOTARY PU LIC STATE OF FLORIDA COM 3I JN NO. CC2SO331 M•: COMMISSION EXP. APR. 76,1(97 C.C.F. r j, 0 NOTARY BOND 3 S, Electrica TOTAL DUE 19 -9� Date 6v Plumbing Engineering