BP2002-345PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N.Ev 2ild '!venue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 305- 756 -8972
Datela O Address 1 . > 1 Tax Folio J t
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Legal De cription c) ---; l(.44‘ Designated: Yes
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Owner's Address
ssee/Tenet
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Contracting Co. • • I 1 1 J/ l2 !
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IF.THERE:Ig iO PLRMPT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
• T'JII3(E WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
• • • •
...... BEFORE CALLING FOR ANOTHER INSPECTION.
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Permit Type; tdittle one) 'BUILDING ELECTRICAL ( PLUMBING MECHANICAL ROOFING
WORK DESCRIPTION:
re of owner and/or Condo P
Notary as to Owner and/or Condo President
My Commission Expires
Master Permit #
Phone
Municipal # O)L ('") )' Competency # Ins. Co.
Date
soy - 009-ix)-he-7/
Square Ft. Estimated Cost (value)
Date Nary as to
y Commissi
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 ANY 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). 1 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 all disciplines.
OWNERS AFFIDAVIT: I 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 con • • do the work stated.
wner
•
s My Commission DD150048
of o p"' Expires November 15, 2008
FEES: PERMIT ®O RADON C.C.F / 1 ° 'w NOTARY ,' , OO BOND L....5 ' 00
APPROVED: TOTAL DUE (3 ( 2 0
Zoning Building i Electrical
Mechanical Plumbing ///.. / Structural Engineer
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