PAINT PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 3/ 1 Job Address I � N E. 9/ S7 Tax Folio 1/ — 0 ( e/3-3330
Legal DescriptionSiN 6E Ni..) e(L/M iouSE Historically Designated: Yes No 6---
/ Tenant J O - A 0 1 e C-1'1 i-t Yvl b /e y Master Permit # 42 . 7Q
Owner's Address P/_5 . 6
• 7/ ST ST i/Y) I t fl'v4/ SA O r 2S Phone 75
Contracting Co. 6 L.c /A- t E0.-- Address _
Qualifier SS# Phone
State # Municipal # Competency # Ins. Ail 41
aK a4 ("v
Architect/Engineer Address l CI (t ' \
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION T,4- / N T ((s E )( T P IO1 - a in c /tea D lA. //- /J 7E 70 w//IT[
Square Ft. 006
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 contractor to do the work stated.
3
ignature of owner an . or Condo President Date
Notary as to Owner and/or Condo President Date
* "; Commission Expires:
FEES: PERMIT 49 RADON
APPROVED:
Zoning
Mechanical
Building
��
17 r P MV 'tton nianIoC3 EXP.
C.C.F. t G,C 7 NOTARY 5 BOND
Plumbing
Estimated Cost (value) 4.2560°
ture of Contractor or Owner- Builder Date
otary as to Contractor or Owner - Builder Date
Electrical
Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date d Job Address f'( A) , �i JT Tax Folio
Legal Description Historically Designated:/Yes No
/ Tenant ' JO — A C__,11.(4 4, 4/0-7 Master Permit #
�
,
Owner's Address l YS A/ ST N N. E 6 ! "! [ , Phone 73 9 -so/ 3
Contracting Co. z e, (.J MTe Address
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder
My Commission Expires: My. Commicsiort Expires:
.7
n
o�
FEES: PERMIT 4'&'- RADON
'PROVED:
Building
Plumbing
/Signature of Contractor or Owner- Builder
0
0
Qualifier SS# Phone
State # Municipal # Competency #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION PAl l En) 7712.E K..00 F = w H7`, 7) c 0/1-7 re
Pro -t ? 1th (SSE 775/7✓ 7 Pi I A/
Square Ft. a 00 0 Estimated Cost (value) 4 /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 contractor to do the work stated.
ate
Date
/y/9•q5
C.C.F. S v NOTARY Lc ° TOTAL DUE
Electrical
Engineering
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building f I 1 S lt,1
Legal
Description
Address of
Building
Lot
l
MIAMI SHORES VILLAGE. FLORIDA V
❑ DATR /1 / 195 f -
PERMIT N? 4588 Contractor's
❑ License No. ' S
El Work to be performed under this Permit
Z ti
Architect
Contractor
or Builder 1 Ft • . l
B1
r
Subdi-
vision
Value of
Project $
Amount of
Permit $
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees. /
/`
.
Signed. t '' _ / � BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
^\ C O R B UILDER BY AUTHORITY BA
J v