575 NE 87 St (10)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date 5 -14 -91 Job Address 575 N.E. 87th Street
Tax Folio
Legal Description Master Permit #
Owner / Lessee / Tenant Mohammed Shaw D.B.A. Kwik Mart
Owner's Address Same as above Phone 756 -5862
Contracting Co. LANGER Electric Company Address 7389 N.W. 8th Street,Miami
Qualifier Roger E. Langer SS# Phone ( 305) 266 -6777
State# EC #0000099 Competency# Ins.Co. Travelers Ins.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION Repair to panel
Square Ft.
Estimated Cost $300.00
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 and zoning.
Furthermore, I authorize the above -named contractor to t work stated.
Signature of Owner and /or Condo President 5 _natu.e "of ontraEtor or,_Qw
Date: TM ` ��� ._
'rotary as to Owner and /or Condo President Ntct4 s to Co i rector or Owner - Builder
zy Commission Expires: My 'ommission Expires:
k . * * *
'ERMIT FEE: APPROVED:
Zoning Building ctrical �'�, *61
_ Mechanical Plumbing Engineering
Fire Other