1993 PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 3- - 6 1—q3 Job Address (4-11 N• C, 63rd S Tax
Legal Description Z // 7 A8'G /7ifry,1041,3 S - 8 '8 5 /
Lessee / Tenant ► !(,1%rN a 4, i 6 ? I°,
Square Ft. Hstimated Cost(value)
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
APPROVED: Fire
Zoning Buildii
Mechanical Plumbing_
Dat
gnat re of Contract
ry to Co
My Co ssion E
Folio //32
Master Permit # 3c45
Owner's Address `1 2 Q3 re Sr. Phone c�b- ! O to g
Contracting Co. , :7?%/AVGE'AZ Address
Qualifier SS# - - Phone
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle ond: BOLDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
—WORK DESCRIPTION
?t1(141)46 eXT 12 10 le 1
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, S[GNS, 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 w)rk stated.
of
r OFFI I�O'1f'FL4t'
• t Y � /%% I ERRANTE
CC�x"aa • v • •, •� r
11O1 1 �. EC '' • e
P =-
er-
ui er •
MISSION EXP. AUG. 2,146
** * * * * * * * * * * * *
FEES: PERMIT 7 -
° d RADON C.C.F. NOTARY TOTAL DUE 1‘(160
/ 6i1)
*
*
**
Other
Electrical
Engineering