PAINT PERMITAPPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
3/ 1JE 6 1 I 2 O(2 I l
Date Job Address � 1 Tax Folio � olro
"
I _ r 1
Legal Description Q
Lo- I A ' 1 /ZtI d C 41 �t a <<e� Z
Owner / Lessee / Tenant oo KJ' / /Jk to r Master Permit # ...360
Owner's Address `C'S / 1J E / ( Phone - 7 3 7 4 -932,6
Contracting Co. 0 wr IefeJ Address qB1 G C ( .2
Qualifier D CV ►' 1. €L_ SS# - - Phone
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUU DING ELECTRICAL PLUMBING MECHANICAL / ROOFING PAVING FENCE SIGN
V Gt-4 y^ 1_ r V' (Jig- ,p�
WORK DESCRIPTION � � � } C �� 0 � � � ad 0 - 1 41 7Cv ,
Square Ft. Estimated Cost(value 3 d-
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 co and zoning. Fujthermore, I
authorize the above -named contractor to do the work state
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
Fire
Zoning Buildin
Mechanical Plumbing
Signature of Contractor or.6wner- Builder
Date:
** * * * * * * * * * *
Notary as to
My Commission
FEES: PERMIT 37 RADON C.C.F. . 512 NOTARY
TOTAL DUE dB
**
Other
Electrical
Engineering
T e
• A3 1 V PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job A
/ /' qj ✓ f n
Date Tax Folio )) 3 �� G�
Legal Description no(cSP -/n �� IistoncallyDesignated: Yes No V
l 'Owner/Lessee / Tenant 1 h 0 rna ' 4-11-1(0)-11/k Master Permit #
Owner's Address "T / N £ 9( J / R e-e r
Contracting Co. 0 W n e f Address 1 (5 / b C ? S 1 E
Qualifier SS #, Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one • BU DING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Q
•
WORK DESCRIPTION (� f use • a ,Q frh� et,5/2 P- U
Square Ft. Istimated 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 1t work stated.
Signature of owner and/or Condo President
Notary as to Owner and/or Condo President Date as to C
My Commission Expires:
FEES: PERMIT 6, D
Date `Signature of Contractor or Owner -Build
My Commissio
ne 30,S
AFFICIAL NOTARY EAL
NIE L. ECHEVARRIA
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC 959556
MY COMMISSION EXP. BY: SEP. 3, 2004
RADON C.C.F. / . D NOTARY 6 BOND /
APPRO T � : s\ TOTAL DUE L ! , - D - 5/VA/
Zoning � ' (��.e Building Electrical
Mechanical Plumbing Structural Engineer
Dat
3/ / 6 /
Date
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: r'
OWNER' ; N
ADDRESS: 451 ** C )
******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: Li C " Y) . E . )
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
*************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
All Elements on the site must be listed and indicate the color to be painted.
Walls } o n � o ) ��' % S a� /
Fascia
Soffit
Roof A11
Flower Bins � Sin) - "W'
Shutters
Awnings
Chimney
Doors and door jams
Garage Doors A) / TA-
Railings / /
Decorative Metal
� l/9
All brick (simulated or regular)
Stucco Banding rJ) A
Any other stucco features n J
.
Accessory Buildings
Other
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
constru on and zoning. I authorize the above -named contractor, if applicable, to
do th j . r stated. Furt s • r , the paint colors will be as per the attached
Signa re of Owner Date
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED:
Building Off / al
3/..)7M
Date
Signature of Contractor Date
1
c)
0
r
0
cn
Pt)
cn
H
H
p
Zi
td
tri
cn
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **