1997 DRAINFIELD 91 NE 91 STPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date -/5 Job Address 9 1 / V T / 57 Tax Folio
Legal Description ('' Historically Designated: Yes
Owner /Lessee / Tenant J � S ■ r II} "� r r t Master Permit #
Owner's Address 9 1 N F q 1 Phone - )S 1- 7 gin '0 ' ' 7M1
Contracting Co. 4 //',,7(,, S , f-/— i7cyrk, Address
d ri 6 in 1 Et)/
Qualifier
State # Municipal #
Architect/Engineer
Bonding Company Address
X60 Sc J 3S C /tt
SS# - Phone r 7 e, 6
Competency # Ins. Co.
Address
Mortgagor Address e.b O a - y s
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION `)
Square Ft.
,. Y P49 Wm. MARK WOODARD
? ,., c, COMMISSION # CC 625712
IR c EXPIRES MAR 2, 2001
ca
^`v BOND THRU
9 �OF W ATLANTIC BONDING CO., INC.
FEES: PERMIT 3 ' RADON
300 D/r-
(v/ 7 � //4/7i
Notary as to Owner and/or Condo President
My Commission Expires:
1
9a -i-a. C " (454 --- / 7 /5'• y 7
Sign a of owner and/or Condo President Date
/U - /6 7 7
Date
C.C.F.
Estimated Cost (value) ( � 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 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 co. actor o d the work stated.
APPROVED:
Zoning Building
Mechanical Plumbin
/7
1 /:
Signatur '• / . actor or Owner - Builder
//,
Notary as to Contractor or O wner- Builder
My Commission Expires:
Electrical
Date
Date
.spiNsf PG6 Wm. MARK WOODARD
a o 4:1 ‹g, COMMISSION # CC 625712
1"'I c EXPIRES MAR 2, 2001
qF O � BONDED THRU
F F� ATLANTIC BO CO., INC.
/S) ° NOTARY BOND 30z)
TOTAL DUE 5 3
Engineering