PAINTDate 0") Job Address 7o
PE 92 51 - Tax Folio o�� 10 00 o 01 m
Legal Description to , e h � G qt P rvk i Historically Designated: Yes No
1 4wner/Lessee / Tenant J)i9 ru C 9SOA) Master Permit # 513 to
O Address '02$ A- 90? s'r Phone,30 5 7 .5 — V & $ `'
tractingCo. C. )/f"rhv_ ,4.1vf1, J IC Address 8400 /i V/A
�ualifier SS# ' on — 7 10 -5 / l -71 8 V
Phon
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State # Municipal # 'Competency # Tns. Co. /f !f* i We L[/. /lam
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDIN EL CTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTIONS ?,:e 5 c e c
leci
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
t U'rrJat�jC"�e,' o►o 4V
Square Ft. Estimated Cost (value "(// 75
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.
OWNERS 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.
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Agr
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as o • er
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ondo President Date
0
My Commission Ex
FEES: PERMIT
,�,► .
i„ (, sdoPf
ANG ! BECK
r OOMM{SEION NUMBER
CC786697 •
OFFL° •9y NOV COMMISSION 2002
RADON
C.C.F.
Notary a to Contr ctor or Owner- Builder
My Commission Expires
NOTARY S., as
OFFICIAL KOURY SEAL
- a R A. ANGELA AR BECKER
Y PV
cvMwasuON NUMBER
CC786
'lll' Q RES
F f�0 IAY NOV. tg
BOND
TOTAL DUEL , o�
Da e
APPROVED:
Zoning Building 711 '� Electrical
Mechanical Plumbing Structural Engineer
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: o2 /We z4
OWNER'S NAME: I PHONE: 7, 9- avicr
ADDRESS: 9a S iva 92 sr
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: 9 2 5 /t/( ` Z 57
CONTRACTOR & LICENSE (if applicable 6„,, ( �/ .2q �_ v COMPANY NAME )4 4.t /L r HONE 105 21,/ # 7vo
* * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed an
Walls
Fascia £v/4, t--
Soffit
Roof ,u/4
Flower Bins ,v /14-
Shutters
Awnings A/ /!t
Chimney /r//-
Doors and door jams /rti/' t
Garage Doors ,ti /
Railings N/!4-
Fences /i-
Decorative Metal ,t/ /,
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory Buildings
Other
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. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will b s per the attached
les
Signature of Owner
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROV
Building Official D1te
Si
indicate the color to be painted.
ontractor
O
w�
C)
0
H
nature
Date
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
as
of
Li, co