PAINT PERMITNo
My C
Condo Presi t Date
FEES: PERMIT Vi ' RADON
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i
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date / Job Address 2,'o we= '/ —s• Z Tax Folio
Legal Description Historically Designated: Yes No
Master Permit # 7 3 �J
/ Tenantf 1 / 02 4, j /'/ •
Owner's Address 2 . 1 i ✓6' 4 7/ SL Phone
Contracting Co. Address
Qualifier SS# Phone
State # Municipal # Competency #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUIILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIP'T'ION A »1
Square Ft. Estimated Cost (value) /.2
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.
owner and/or Condo President Date Signature of Contractor or Owner- Builder Date
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
C.C.F. (• a Z d NOTARY BOND
APPROVED: -
Zoning Building r
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date // Job Address Z.Sv A 9/ 527 Tax Folio g g.� '6 /., //49,/O
Legal Description 6 _ e S .C�,f!°/ /
6iii Lessee / Tenant it/ l4) we-1 j j-2 , Master Permit # ��rc
Owner's Address 2 S Z 2 P V C - 9 7 5 7 . Phone %S 7- / y
Contracting Co. Address
Qualifier SS4r . - Phone
State # Municipal # Competency # Ins.Co.
4
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ra -,4 7 plc 7' CAL Ca .t"+ zt5
Square Pt. Estimated Cost(value)
Notary as to Owner and /or Condo President
My Commission Expires:
APPROVED:
as to
y Commissio
0 P400
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.
A/
Signature of owner and /or Condo President
Date:
at re of Contractor or Owner- Builder
Date:/ 7;7 Q /9�
** * * * * * * * * * * * * * * * **
FEES: PERMIT 3�� RADON C.C.F. ).5 NOTARY -c TOTAL DUE
Fire Other
Zoning �uildin ) Electrical
Mechanical Plumbing Engineering_