PAINT PERMITLegal Description
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address (2 9 (OE ! 1 S* Tax Folio
�c i aSUc," -\ Historically Designated: Yes No e/
1,)
/Tenant C \ L. VAC. k ' r l i r C k , Master Permit # 1 4 5 i t k
Owner's Address Phone 9 0 7s 9 ego 5
Contracting Co. 0 \..x.. 1 "E te—
Qualifier
g a°
State # Municir
Square Ft. k .36 L
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
RADON C.C.F.
Address
SS#
creme • 2o'r 7 ss — Colonial Red • reaa,
Phone
Architect/Engineer elt.pS
Bonding Company , Addn. l` U n _
Mortgagor Address c � , �
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 6. t VA 1 N 2: - ` Q ac 0 r CJ4 c i o c 2_.lk
trirn 0 • F o►n1 Door . c (CDrS c t,c
Estimated Cost (value)
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.
OWNERS 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.
NOTARY
Electrical
BOND
TOTAL DUE
? u9.1!JD •
APPROVED:
Zoning Building
Mechanical Plumbing Structural Engineer
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 3 •a" • Job Address 3 (- 1 A) E 9 I L 5$. Tax Folio
Legal Description Historically Designated: Yes No
ssee / Tenant Ole 4 c iJ I'OPa v Master Permit #
Owner's Address J3Z q }Ve a 111 i , Phone R S1 - s 1 il
Contracting Co. P ci e Qk&�LVLIre, Address i (-1o\ )1A Vv 1 3 S+,
Square Ft. `, 7) (00
Qualifier
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one). BUILDING , yam
WORK DESCRIPTION 1 ' ! (o � l R (4 r u0:4:14(
t4vOct , &reok, (i,411,1ck udA-(-c cfC--(Aki-t-c
Estimated Cost (vIue) , / 0 Q
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 e: ating co studio d zoning. Furthermore, I authorize the above -named contractor to do the work stated.
AIL 10
e of owner and/o Condo President Date
Zativta Ath
FEES: PERMIT
LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
RADON C.C.F.
SS# Phone
NOTARY TOTAL DUE �1p
• ., •
Signature of Contractor or Owner- Builder Date
Notary as to Owner and/or Condcf'President Date Notary as to Contractor or Owner- Builder Date
My Commission Expires: ' , Pce 11107 '2p, My Commission Expires:
5 � PJQF.0 /Or• �
APPROVED: 414r Zoning Building g e Electrical `
Mechanical Plumbing Engineering