PAINT PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
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Date . / �� AL1 Job Address / O) 0 ✓ I P / 2 Tax Folio
Legal Description
/ Lessee / Tenant
Owner's Address /e ) 0 / C7 a 's --7-- Phone
Contracting Co. C• S /i- )1 Q/Ze Vj Address , 33 //12/ 93 )e 671 , , /
Qualifier � kL ,c7 Y)Ae II SS# Phone 7 'x`7 -- G :2 7
State # Municipal # Competency IP /O 7/ Ins.Co. /val.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION d G i 1) 7
(1'Gi I--a
/‘6/
•J V
Square Ft. Estimated Cost(value) J
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.
WNER'S I VIT: I certify that all the foregoing information is accurate and that all work will
done i om• lance with all applicable laws regulating construction and zoning. Furthermore, I
riz a a,.ve -named contractor to do the work stated.
Signature of owner and /or Condo President
Date:
N•'ary as to Own nd /or Condo President
M Commission E
FEES: PERMIT 3 7-0
APPROVED:
//4 / k/ 0 5 ex
(2Y P0 OFFICIAL. NOTARY SEAL
O e (7 USETTE D ZAMORA
2 w COMMISSION NUMBER
** * * * * � , ' . :UP.. ' QC0189 2
�j MY COMMMSWN EXP.
OF pk. JUNE 6 1994
Fire
Zoning Bui
Mechanical Plumbin
e
Signature of Contractor or
Date: 6/2' /
Notary as to Co tr pto3� Q7r
My Commission E I; , t . � e - :, 0
< SCOTT w DAVIS
\ )f. * COMMISSION NUMBER
EXP.
JAN. 26
Master Permit #
e1Fo
TOTAL DUE
wilder
349
Other
Electrical
Engineering
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