PAINT PERMIT** *
Legal Description
WORK DESCRIPTION
)
Signature of
Dater, 112o)
APPROVED:
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date �I !'i Job Address 102-0 ti' ,q 2- s
6 - :Mer/ Lessee / Tenant ✓ OYr �+ } /-1 P � , All �, )
Owner's Address / d a 0 /V E S�
Contracting Co. C 1-/ ,.5"71,0,r)
QualifierC r 2 ,5 /7 CV/2e!)
State # Municipal # Competency # /a /gy
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN a k0.01 "9
J
R'j d A/ wall
Square Ft.
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
aut th wove -named contractor to do the work stated.
er and /or Condo President
tary as tfOwner and /or Co do President
My Commissio
JUDTTH T SHERRY
NO ?ARY PUBLIC STATE OF FLORIDA
/COMMISSION NO.0 179642*
MYCOMMISSSON EXP. MAR. 26,19%
FEES: PERMIT 3Z -TO RADON
Mechanical
/44-e3r P 20).
Address
Tax Folio 1 ' 20x2 002-0 0
Master Permit #251525642_
Phone
Phone / —
Ins.Co. „/40' k/4
Estimated Cost(value) .4/00 .0
4i 1d . c
t. , Y09jj Iall @Z' SEAL
7 .�i BARBARA ANN FUOAZZI
li
St" "� 0 COMMISSION NUMBER
'.= Q CC360191
-7 /` MY COMMISSION EXP.
G OOF F\ MAR* 9 19
r
NOT
* * *
C.C.F.
Fire
Bui
Plumbin
Signature of Contractor or Owne - ilder
Date:
Notary as to Contr
My Commission Expi
* * *
Y Sod TOTAL DUE
a h
Other
Electrical
Engineering
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal
Description
Lot
MIAMI SHORES VILLAGE, FLORIDA
DATE 194
PERMIT N° 4536
Work to be performed under this Permit ' 1 " "'''+�
Owner of
Building
Bl.
Subdi-
vision
Address of x i e Value of I4 Amt. of / 4 ` F ' '
Building t r ( Project I Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in.,t appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance wi any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be rev Iced
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. �
, Signed• By "F'
INSPECTOR
In consideration of the issu nce to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto ancLin strict c formity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit iNassu d responsibility for 411 work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY
Contractor's
License No
AUTHORITY