2001 PAINTkC 4 v,134 /PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ‘5( r )0I Job Addresss 1 473 9 1 7 rL2 . Tax Folio
Legal Description C Historically Designated: Yes No
Owner/Lessee / Tenant t a � . -- \d`CC�Z Master Permit #
Owner's Address / !) `z l
/
Phoney 7 — c QD o o
Contracting Co 1 Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Address
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one
WORK DESCRIPTION/
Square Ft. Estimated Cost (value) • c�c
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
construction and zoning. Furthermore, I authorize the above -named contractor to do the wo
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date Notary as t
My Co
My Commission Expires:
FEES: PERMIT
APPROVED: t1pt
Zoning
c Z /.�e Buildin
Zo
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Pci :
C.C.F.
Address
Address
5 ,
igna • e of
0
ssio
n
ne in co . liance with all applicable laws regulating
. ctor or 0 e er -Buil . e
ctor 0
Fai PUBLIC SPATE OF FLORIDA
COMMISSION NO. CC71410.3
MY COMMISSION EXP. MAR. 1,2092
Date
' I/ ° NOTARY L
7 -1 9 -0 /
'cal
BOND
TOTAL DUE
Mechanical Plumbing Structural Engineer
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATO 1
OWNER'S NAMEkLINL. C . - (Y._(-1 Ea PHONE:
ADDRESS; ( 1 t --((k 1
* * * * * * **
ADDRESS OF SITE: n&C A.5 -
CONTRACTOR & LICENSE (if applicable) �1 /t
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls
Fascia Scc
Drip Cap/Drip Edge
Soffit )
Roof ///k,
Flower Bins Nhk
Shutters ,P /k
Awnings jJ/R
Chimney
Doors and door jams ,v /A
Garage Doors A/'
Railings ,v/A
Fences
Decorative Metal A r__Cv�l
All brick (simulated or regular) 'r�� STA
Stucco Banding N//N
Any other stucco features » /A
Accessory Buildings
Other Op.<
m F
N 6 D O
CD O w
a � C1 CO %
3 7
OWNER'S AFFIDAVIT: I certify that all the foregoing informa v O
and that all work will be done in compliance with all applicable li
construction a g. I authorize the above -named contractor Q "
do t or - - d. rthermore , the paint colors will be as per tY
sa
Building Official Date
71'
(
Signature of Ow `Q Date Signature of Contractor Date
* * * * * * * * * * ** ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: ( - CD
OWNER'S NAME: ■iac(l-ki- 7 _ YEN- 2 2- PHONE: '7s -o60
ADDRESS: f(3I N `t l -- T - L(r(AE
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: � cc /As Ax ci
CONTRACTOR & LICENSE (if applicable) IU f/)
COMPANY NAME: PHONE:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
All Elements on the site must be listed and indicate the color to be painted.
Walls `b2--s c- ic,fTh�
Fascia C_-\ mss, G ,�,, --, ,
Drip Cap/Drip. Edge ° '
Soffit N/A , '5fd�
Roof tJ)A ?CnQ>
Flower Bins N/A ro
Shutters A)/ii\ tli
Awnings P/^
Chimney 6v/A
Doors and door jams itth\ C\ f' 65.1 L
Garage Doors GW" -D
g Picrl
Railings /) //\ w
Fences N i A
Decorative Metal 0At CeArrem
All brick (simulated or regular) ('��n��.v,�, \e - LAS
Stucco Banding 0)/,
Any other stucco features p/Ps
Accessory Buildings N /R-
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' stated. hermore , the paint colors will be as per the attached
Si nature of Owner' Date Signature of Contractor Date
* * * * * * * * * * * * * * ** ***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED:
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Building Officia4' Date 4/23/01