PAINT PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
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Date Z ► 0 0 J o b Address r � . . � - 1 � J 1 ,� 'M\0 Mm Tax Folio 1 1 -32 - 0 S °O 00 6 o •
33V3rS
Legal Description Lep V 5 I orb �,. K Historically Designated: Yes No
eoy Lore. P 6 Yeti
/ Tenant�� w � S Master Permit # `f
Owner's Address 3 I (Os .1% 30 S � (03 .
Contracting Co.
Qualifier SS# , Phone %
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ?0■,.W\, Do Vs
Square Ft. Estimated Cost (value$ 'S 0 •
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 the work stated.
•
owner and/
Condo President
Owner and/or Condo President
D
•
Signature
No
M
tILDA PERED
MY COMMISSION 1, CC En935
14.Q$ s pa' EXP RES: Oct 23, 7=
1-3 OTAxV Pa. Notary f 7vIC) c, r.nr.< •t9 f:S.
FEES: PERMIT
APPROVED:
Zoning
Mechanical
RADON
10
Building
ate
D
Address
Signature of Contractor or Owner- Builder Date
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
C.C.F. f NOTARY BOND
TOTAL DUE l/
Electrical
Plumbing Structural Engineer
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: kts D
OWNER'S : �Y1�'�� �v .k2S PHONE:3_� \ °- 9 63
ADDRESS: a-6-1 ' `FG- ° � S � awu, (.... .
ADDRESS OF SITE: 11--S1 C\ • C � 3 4\)\\..o .i
CONTRACTOR & LICENSE (if applicable) ---
COMPANY NAME:
Roof
Flower Bins 1 'g;ieN
Shutters It .c-ro Nf r k C 131
Awnings
Chimney
Doors and door jams k-k C 1'aa°1
Garage Doors 4 C 3 �1
Railings
Fences
Decorative Metal --°
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory Buildings
Other
PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls 1--1C. 3"
Fascia \ c_ 32— Lid% Al
Soffit V\ C_ 32- an�q sBuuds
1
standish white
:A - 52 •
OWNER'S AFFIDAVIT: I certify that all the foregoing informanon is accurate
and that all work will be done in compliance with all applicable laws regulating
construction and zoning. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will be as per the attached
s.'spies. r \ ( 1
\Ck2A 60 1
Signa ' e of Owner Date Signature of Contractor Date
***************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APP D:
01, /a
Building Official Date