2001 PAINT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date O Job Address 11 r16 1N`L 6-3 ':�" ' Tax Folio
Legal Description I Historically Designated: Yes No
Owner/t essee/Tenant— 1 L k-1 R.rr'-V- �'T�a ujgE:�t A)S Master Permit#
Owner's Address Lj l o •�G • 1 P3 C`TT_, Phone
Contra<xing co. �''L l.t)N �J2.� Address
Qualifier SS# Phone
State# Munitapal# C'ompmxy# Ins.Co.
Arcbitect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUMDING ELEC 1MCAL PLUMING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ?Ptk N T
Square Ft. �"r l7 Estimated Cost(value)j! �
WARNING TO OWNER YOU MUST RECORD NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR ENIPROVIQ EWM TO YOUR PROPERTY(IF YOU UMM TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made toobt9n a permit to do work and installation as indicated above,and on the attached addendum(if applicable). I certify that all work
wdl be performed to meet the suds of all laws regulating conshuction 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 authorme the above-named contractor to do the work stated
S' #mer Andicir Condo President Date 1044
of or Builder Date
Notary werto 1 Date Notary as to Contractor or Owner-Builder Date
My Expires:GWYS I VILLAR' My Commission Expires:
N()TARX pUB=$TATE OF FLQ?i3i?'•
C0MmsSION Na CCJ141G3062
�S6 ON
l3XP MAR.
FEES: PERMIT�QRADON C.C.F. 1 40 NOTARY BOND
APPROVED: TOTAL DUE
Zoning Building Electrical
Mechanical Plumbing Structural Engineer,
MIAMI SHORES VILLAGE'
Paint Color Approval and Agreement
DATES
OWNER'S NAME: .-� ,oS PHONE: —2S/_d
ADDRESS 1 1� --)I .E .
ADDRESS OF SITE: c-p ryng, as Ac3oy� ,
CONTRACTOR& LICENSE (if applicable)
COMPANY NAME: PHONE:
All Elements on the site must be listed and indicate the color to be painted.
Walls 5 1{&R..w1I1 UL L rPchs &1PRge %A fl�vON C2-t
Fascia (_A-)A 0
Drip Cap/Drip Edge L_A)y� NSE 0
r0
Soffit L AAA t- z
Cn
Roof 1 A,-r
Flower Bins ( ��,�► ro
r
Shutters
Awnings
Chimney
Doors and door jams
Garage Doors W" tv
,
Railings _ ,bm 0
Fences ,- cn
Decorative Metal 1:1:E
All brick (simulated or regular) tA�-F ,
Stucco Banding
Any other stucco features '
Accessory Buildings
Other
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. I authorize the above-named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will be as per the attached
sam les.
Mign a of Cfwner Date Signature of Contractor Date
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Building Official Date 4/23/01