875 NE 92 St (7)�
Date C /V 6 7 Z Job Address 8 A ' 6/2- 'S
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Legal Description vY� c 4' 3* g b 1 iS / a/
Owner / Lessee / Tenant g i 4 07,4
Owner's Address
Contracting Co. Co 6/11/(//6 2C
Qualifier
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
%/r/ »1v ✓Lil/ 11 /!4 6-2
Phone 1 2-8 14
Address
Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIG
WORK DESCRIPTION 00
Square Ft. Estimated Cost(value)
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 INTENT
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, an
on the attached addendum (if applicable). I certify that all work will be performed to meet th
standards of all laws regulating construction in this jurisdiction. I understand that separat:
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 wil
be done in compliance with all applicable laws regulating construction and zoning. Furthermore,
authorize the above -named contractor to do the work stated.
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
APPROVED: Fire
Zoning Building
Mechanical Plumbing_
(11Y �Address q / LL Z2 N / ` 7 P
aoor Zx3 0 1i L s co . fcci
D7 / 4 7-9y
Tax Fond/ j. of 63 P .30
4 gte
,Master Permit
Address
jfp'`
Signature of Contractor or
e : r/16 y /9,/9
Nc)e1r
Phone 7`f x - 3 2
Other
Owner - Builder
•.�tiat,wt
Notary as to Contractor or Owner- Builder
My Commission Expires: /e«Arc- ,4- G /'(
NOTARY PUFLIC STI E CF U En
MY COfit ERPW 5 61,
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** * * * * * * * * t,,, * Sgern , a , p
�Ie. �.�:? ..0 4�1 n,�1+8
TOTAL DUE T/6
FEES: PERMIT 1/% RADON C.C.F. NOTARY 5,49 ,a2
**
Electrical
Engineering