48527Legal Description
PERMIT APPLIC4TION FOR MIAMI SHORES VILLAGE
Job Address 47 r1 /' ' t CilkeerTax Folio
Historically Designated: Yes No
Owner/Lessee / Tenant ° �/� # /�'� C4 %mil .,,A0144.14- Master Permit # � L 7
Owner's Address
C 72 A/6". ' 98 JE1 Phone 36C - 7s1 7 co 7 •
�
Contracting Co. R• t� /J s. JET cr / / ta1� ,d/'L Address igq 52— //D ' Z
Qualifier 06P4 c N 641<11. SS# - Phone 5S ' 1 7K/
State #
Architect/Engineer
Bonding Company
Mortgagor
Municipal #
Competency # Ins. Co.
Address
Address
Address
Permit Type (circle one): BUILDING ELECTRI AL PLUMBING MECHANICAL ROOFING- PAVING FENCE SIGN
Ao 461.,
WORK DESCRIPTION
Square Ft.
Estimated Cost (value)' /Z6
WARNING TO OWNER: YOU MUST RECORD A NO CE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR P OPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR N)TICE 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 MECHANIC WORK.
OWNERS
construction
iture of
d_.
`onin I:' certify info accurate
work and that all
do the work be done in compliance with all applicable laws regulating
authorize the named contractor
Notary as to Owner and/or Condo President
My Commission Expires:
STEPHEN E COYr.4`
st @te of tultert44 ,
my Corm. .. r , if
Comma: CM 1. `.
FEES: PERMIT 0 - RADON
APPROVED:
Zoning Building
Mechanical Plumbing
5
lure of Con
p 'r
otary : l o Con i - ctor o
My Commission Expires:
ror
1I.
er -Build
•a
/3
OP
Date
,‘P,RY PG OFFICIAL NOTARY SEAL
? a' ANGELA M BECKER
* .. ! * COttliaS ON MINIM
.4 w5! 4.:. CC786697
9j cb BIN CONRA9SSION EXPIRES
C %.0 NOV. 15,2002
C.C.F. 1 .,� DNOTARY „S - 0 () BOND 3 D n
TOTAL DUE 30-0, °r
Electrical
Da
Structural Engineer