Loading...
PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Yh ti j” Job Adaressg y P W E 93 S /- Tax Folio Legal Description Owner/Lessee / Tenant - 1D (, ti '13,46.e( Owner's Address �3 V � / o .3 S Contracting Co. $ c i F Qualifier SS# State # Municipal # Competency # Architect/Engineer Address Bonding Company Mortgagor Address Address Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION %9 i -- / 1 X Teri / n— ' t l2 r R t I 1 n (f Lz) F F Square Ft. Estimated Cost (value) / o u WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DC 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 perntt 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 state Signature of owner and/or Condo President Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT RADON' APPROVED: Zoning Building Mechanical Date Signature of Co rn Notary as to Con My Commission PJ 3 ©H C.C.F. 4 NOTARY It/01 ated: Yes )( No Electrical I er Permit # 4 7 / '/3 v 75 `/ 2 `/ / `/ n er- Builder BOND Phone Ins. Cc. ■ TOTAL D1J?(_ Date ` / //tilyy Date Plumbing Structural Engineer I PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date)//(/3 Job Address 3 ' rV C 9 3.37 Tax Folio 4/ -% � /5? V)/ Legal Description / �� � p � i / � ( > ' / si 3 Owner / Lessee / Tenant ,1 o S• 1J be Master Permit Ik Owner's Address 3 9 9 A/25 y;_.3 s%. Phone N I s `/ I y Contracting Co. "r, 1b/c, Address Qualifier SS# - - Phone State # Municipal 11 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 •�o "" Square Ft. Estimated Cost(value) Notary as to My Commissio APPROVED: ' c- �tY r FICIAA��, � � O. AR SEAL C'er :8f o §cbt�F` PDKM 7* •yR 1' COMMISSION NUMBER . I , Q CC255237 � 4. MY COMMISSION EXP. OF PL t JAN. , 9 1. X I Fes, 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 he above -named contractor to do the work stated. Signatu r and /or Condo President Signature of Contractor or Owner- Builder Date: /7 - Date: nt Notary as to Contractor or Owner-Builder My Commission Expires: * * * * * * * * * ** FEES: PERMIT J/jZ RADON C.C.F. - �� NOTARY -5:4 TOTAL DUE ( )() Fire Other Zoning_ Building Electrical Mechanical Plumbing Engineering