PAVINGDate
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
((OWNER C TO c- RETAIN COPY)
Job Address /O ��' / / � S ' L
Folio /l fj K- /,x ®,!/ttJ
Permit #, 37, ji
Tax 4
Legal Description essee Tenant
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Owner /
Lessee / yLJ /� �� �`
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Owner's Address ,/ 2f ' 4 / Phone 75
Contracting Co. /, /v
/ L Address /0 f '7 ? /
Qualifier ��/ Phone
State #
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Square Ft.
Si ature of Owner
D a 5)e-rm
Notary as to
My Commissio
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Competency #
Permit Type (circle one): ILDING ELECTRICAL PLUMBING MECHANICAL FENCE SIGN
WORK DESCRIPTION SG S N/ L o d
and /or Condo President
ti
Owner an /or Condo
n Expire �N1OpTARY PUBLIC. SPAT 0F1 IUA.
P �N�f COMMISSION EXPIRES: MAR. 21. 1999.
B *DED TNRU *TART PUBL*.UNDERWRU*Rma
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PERMIT FEE: APPROVED: Fire
Zoning Building -"7-
Mechanical
Plumbing
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Estimated Cost
Ins. Co.
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
will be done in compliance with all applicable laws regulatin$$��
Furthermore, I authori3 j7e above -named contractor to ated
Signature
Date:
ntractor or Owner - Builder
Not- as to Contra r Qwner- Builder
Y- WS�RY�+u ®L7C ST OF
My Commission Expiri , EXPIgEc RORI
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Electrical
Engineering
work
ning.