PAINT PERMITS•
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY) r�
Job Address ( �E I �s T��& ) ��'11 Sl�i- � FL, S�3g Tax Folio// .41 , ,Wl /1 d)i9/)
Legal Descriptkn /9Z, p , f Master Permit # ,,,Z2 /e'
Owner / Lessee / Tenant ply c
Owner's Address i6£CO c--o CL T Oce (1--t Ctl ) et- 33\39
Contracting Co. S( L I
Qualifier
State# Competency# Ins.Co.
Architect /Engineer
Bonding Company
Mortgagor Na- . -2-C - G (
Signature of Owner and /or Condo President
Date: Z_ \►11GL
4
Zoning
Mechanical
h1 t v/Z-E
Plumbing
1ivC r i e - - t NC- ' 5 A NA K., M
Address
SS# - - phone
Address
Address
phone
Address 11Cz'43 Cc1S(rrHCNC &-N O. IV
Permit Type (circle one)( BUILDING j ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION ecalv 1
Square Ft. Estimated Cost �,? to ,V
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. 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 contractor to do the work stated.
ary , =s to Owner and /or.r � ru P e e t Notary as to Contractor
./ d[ iI , sP IF FLORIDA
My
* Commii Expires: 'y COMM_`SSIOfd EXP. ES APRILy.6, 19 9 2 Ty Commission Expires:
BO DfD`1HRU STEMBIERAIIMS 8 SWEET
PERMIT FEE: APPROVED: Fire
Signature of Contractor or Owner - Builder
Date:
Other
or Owner - Builder
7.41(7,9V Electrical
Engineering