PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date /$ Z ob Address /092 /l/F 9j " Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant
Owner's Address
Contracting Co. S /2- CCiYLci�/2GL
Qualifier
SS#
State # Municipal # Competency #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle on BUILDIl G' ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION / / e'X 7
Gr/ /, f1 Z
Square Ft. Estimated Cost (value) ,r40>
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 the above -named contractor to do the work stated.
APPROVED:
Zoning
Mechanical
Signature of o
4-r
and/or Condo President Date
6 - O G o- l yo- o
•
• ( as , h.n :,,, TI • • esident bate
y Comm, srflnles: OFFICIAL NOTARY SEAL
O ANGELA M BECKER
2 Sr n compassion NUMBER
• 4, 1 1r , Q CC7$6697
R7Y COMOSSION EXPIRES
OF FLO NOV. 15,2002
FEES: PERMIT RADON
Plumbing
C.C.F.
Address
otary ; ' to Con
My Commissio
NOTARY
Building Electrical
BOND
Master Permit #
Phone
/mil /ree
marl &GOr— 5 Yl7
,C - 3ar - —��
Ins. Co.
1 1
Signatur Contractor or Owner- Builder
4 lost —S Go —NO—
ctor or Owner- Builder
OFFICIAL NOTARY SEAL
0 1' U de , ANGELA M BECKER
1 A t1 COM@pSS1ON NUMBER
Ivry* CC7B6697
O MY COMMISSION EXPIRES
44.. OF F\.O' NOV. 15,2002
TOTAL DUE
Date
Date
Structural Engineer
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ' �it Job Address /a1 f) 4 S7 4' Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant /1' +/ r)PJ . OS 4e. w Master Permit #
Owners Address A2/ f6' Phone
Contracting Co. .S/ Z �Gi�Z� /��f� e 7Gr✓ Address
Qualifier �/.% /Z!y i���UrL SS#
State # C6C 07 W‘_ - Municipal # Competency # Ins. Co.
Address
Square Ft. Estimated Cost (value)
Signature of
and/or Condo President
Notary as to Owner and/or Condo President
My Commission Expires:
APPROVED:
Zoning Building
Mechanical Plumbing
Date
Date
1/0410
Signa
No as to Con
My Commission
Electrical
Phone
No
Architect/Engineer
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 'eo4/7 4Gy
e on
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 pennit 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 • . • • - the above -named contractor to do the work stated.
actor or Owner- Bui�er�
• ctor o °'a`l" r•er.
i�ir LAR
Y PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR 1 002
FEES: PERMIT 0 / RADON C.C.F. ' 0 ' NOTARY BOND
TOTAL DUE
,7_22,-00
Date
as
Date
Structural Engineer
. 'v
y
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: 9,2
OWNER' S Q%cn/ PHONE: 3UJ
ADDRESS: /"1
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: 5?7 (dh yu(7 jt PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls ���7#Z a302 PI
Fascia P' 7 '1 - Aar c= f'
Soffit _ 023 5/0-'
Roof
—7-(L s Wt s t . ci2 Fc3
Shutters
Awnings
Chimney
Doors and door jams 23/2
Garage Doors
Railings
Fences
Decorative Metal
All brick (simulated regular)
-- Stucco Bandin 7 0,9 /G6
Any other stucco features / /JZ. �c�y
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 be as per the attached
s. pies.
ature of Owner Date
***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *., **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
AP "• A'
it i/0
ding Official 'Date
ature of Contractor Date