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PAINT PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLA■ Date3 3 -00 • Job Addressx a_fg N`C. \ R l Tax Folio Legal Description Historically Designated: Yes Owner/Lessee / Tenant C � O6 - 1..A 0 OW i - , Master Permit # 7 r . Owner's Address c \ Phone )( "' c i ^ 0 ©3 Contracting Co) t. Address Qualifier ss# \ - (Phone S 9—o 0 State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor CQO\cC Address Permit Type (circle one): B i ILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION � �� ���'&-+ Square Ft. Estimated Cost (value/ S Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President My Commission Expires: FEES: PERMIT r c 0 RADON Date Notary as to My Commission Expires: 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. Si atur of Contract - e APPROVED: TOTAL DUE S Zoning Building Electrical Mechanical Plumbing Structural Engineer