PAINTa.
•
APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Tax Fo1 io // j/ 4 /5 1 /M
Legal Description // -4-7a, V ‘0') � / Lei) �/I LI Master Permit # Js ;,W /�
Owner / Lessee / Tenant I / ie_ ,R
Owner's Address C. k q • 5f-
Job Address 1L,(0 N E q S '(-
Contracting Co.
Qualifier
State #
Competency #
SS#
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION O I( (1 -e4&texi Or CJr I ou Se
Square Ft. Estimated Cost4Z40O0 , C)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. 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 do the work stated.
Signature of er and /or Con•, President
Date: ./a //0
PERMIT FEE: APPROVED:
Zoning
Mechanical
Building
Fire Other
phone --Z 7- l C O S
phone
Ins. Co.
3
Electrical
Plumbing Engineering
Signature of Contractor or Owner - Builder
Date:
Notary as to Owner and /or Con •o President Notary as to Contractor or Owner - Builder
My Commission Expires: /16 9a. My Commission Expires:
* * * * * * * * * * * * * *
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date .� Q iob Address 1 2-(0 1 v q3 5 Tax Folio
Legal Description Historically Designated: Yes No r- q Owner/Lessee / Tenant i I el Master Pennit # '/t t 7/
Owner's Address /02- 6 /V E 9, ,S Phone — 15 - 7-7 �./O `l
Contracting Co. rO 8 i /�7 !'V eo / 844 Address /! / 0/ co, B Is(. e/9/1i/92_17.1)
Qualifier /To OZ 7 - A i e 7 B/57- SS# ° v AL/ - 3 0 s o P h o n e ? -
S t a t e # / L Municipal # 1 V60 Se Competency # l6/6 0 g Ins. Co. /�/E -
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN --- WORK DESCRIPTION PliEs.5 OR E &L ,9IV 'f /7/9/A)7 7/E Roo f_
0M47 TO I /TE'
Square Ft. Estimated Cost (value) `(OD
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 do the work stated.
Signature of o and/or Condo Pre
Notary as to Owner and/or Condo Presiden
My Commission Expires:
1 4)e)
�i; 1-84
Date Signature of Contractor or Owner- Builder Date
t
ate Notary as to Contractor or Owner - Builder Date
My Commission Expires:
- y7
FEES: PERMIT C-i ' RADON C.C.F. f NOTARY , f • BOND
TOTAL DUE
APPROVED:
Zoning Building d! Electrical
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address 1 () E 6+- Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant In c\ c\ 0
Owner's. Address I Zlp I V
Contracting Co.
cett ti( �Il'� obi
Qualifier SS#
State # t A-1 - 14 q 5 Municipal #
Architect/Engineer
Bonding Company
Mortgagor
Signature of o
My Commission Expires:
FEES: PERMIT
and/or Condo Presi
RADON
tV
Competency # Ins. Co.
Address
Address
Address
Master Permit #
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Q 1 ( Ex i Dr o hour and 30( re( g . .
\Wood -him Whiff
Square Ft. Estimated Cost (value) 1 51RD •
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 do the work stated.
Signature of Contractor or Owner - Builder Date
./ , /L
tary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date
3/.2.T
My Commission Expires:
Phone - 757-7(.005 -
PO, lo l
Phone 1 -0-7- S 8 c��
b
C.C.F. NOTARY ✓� BOND
TOTAL DUE
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering