PAINT PERMITPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address /OS/
Legal Description a n , u ,��,,(�,��0
Owner / Lessee / Tenant fro_
Owner's Address /OS) ,✓'�� q�
Contracting Co. /1// JE4ioiit &-o/ ,F 1Lu 41 Address /2$7,5 Ale- /40-r
Qualifier /(11.0K.A.A..A , gC /J 7)12 A» Phone 0 /15/3
State ° i /6 -' 19//' Competency # / 9 3 , /.- } Ins. Co. 04/O iU
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL
WORK DESCRIPTION ‘-. P1 SSd/1,a dA.44-1 g
Square Ft. Estimated Cosh' ,Z1 4 # " PO
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 ao the work stated.
Si
late
dot -r as
iy Commissia
* *
'ERMIT FEE:
*
Condo President
.nd /or Condo President
ires: Notary Public, State of Florida
*My Comrr*sion Expir*s Aug. 17,*994
Bonded thru Maynard Bonding Agency
APPROVED: Fire
J
CO
Tax Folio 1/- 3? - 0 /6 /O
Master Permit # (
Phone 76 ...
PLUMBING MECHANICAL PAVING FENCE SIGN
Signature of Cont �� or Owner-Builder
Date:
Notary as to ontractor or Owner- Builder
My Commission Expires:
* * * * * *' *
Other
Zoning Building Electrical
Mechanical Plumbing Engineering
PERMIT APPLICATION ' NE FOR MIAMI SHORES VIL
Date Job Address / c5/ / V E F L s Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant —16 4 G r r s s Master Permit # 4 29
Owner's Address / G S ) N6-9 1
Contracting Co.
Qualifier
State #
Amhitect/Engineer
A-a-P
fG �
Municipal #
WORK DESCRIPTION
Signature of owner and/or Condo President
co
T
•
Date
3
Phone rjS / «j
Address
SS#
Competency #
Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRIC L PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
m
N C)
OWNER'S AFFIDAVrr: I -
laws regulating construction and zoning. Furthermore, I authorize the above -named contrac or o
Phone
Ins. Co.
ignature
Notary as to Owner and/or Condo President Date N ary as to Co. • actor or • uilder Date
My Commission Expires:
My Commission Expires:
a aF CI.4L NOTARYSEAL
CLADYS J VILLAR
1 NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
Y COMMISSION EXP. MAR 1,2002
er- Builder Date
(i - f9
C �
FEES: PERMIT n RADON C.C.F. O NOTARY J BOND
TOTAL DUE 4 la 6
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering