62 NE 93 St (12)PERMIT APPLICATION FOR P UNICIPALI[TIES OF DADE COUNTY
/� 11�� (OWNER TO RETAIN COPY)
Job Address 2 k (= 7 I Tax Fol io f/g� �
Legal Description
Owner / Lessee / Tenant
Owner's Address phone .,
Contracting Co. 0 j i Z-- L11 Lc� Address
State 0
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one )p' BUILDING \ ELECTRICAL PLUMBING MECHANICAL PAVING F'EN'CE SIGN
WORK DESCRIPTION
Square Ft. Estimated Cost
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FA.LURE 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.
Signs ure of er and /or Condo President
Date:
N• c ary n s to Owner and /8l&TA p eiV iOrnIRMA
Commission ExpiresMY COMMISSION EXPIREAPRIL 16 9 92
* * * * SOPIDED IMILI SUMBLER A 4S 8 ZE T
Fire
PERMIT FEE: APPROVED:
Zoning
Mechanical
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Competency 0
SS)
Building
Plumbing
Address
Address
Address
Master Permit 0
phone
Ins. Co.
Other
(Engineering
1.s > Cf2) ';U C
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( o 5V
45 Afl6
Signature of Contractor or Owner - Builder
Date:
Notary as to Contractor or Owner- Builder
My Commission Expires:
* * * *
Electrical
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