PAVINGPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date Job Address /94e /1/ - 9,M 1 7 Tax Folio // 3,2a6 /,3 0 210
Legal Description £ P7_ .1:5 74/2--/44.
Master Permit ft gi�290
Lessee / Tenant Mnry Ait'1 4"-/ . 4 s ..fee J /glib
Owner's Address
/ Yo(
Contracting Co. 4r 0 - .Sr C COnscr$fi
Qualifier nl44/4 /epi ",. L ✓(2 SS # # Phone SS - i - °: , '
State# Competency it C T
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL
WORK DESCRIPTION S rAU/VP
Square Ft. Estimated Cost 40--
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.
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Signata R o 1A a Ad /or.mOndo Pre
WA LI✓uu.1...u.Ju ...... . . .J: .n.. ✓. 1 92.
BONDIID Tht.0 iVUi..iif rUu SIC UW ✓EItuJ.tli CR0.
Notary as to Contractor or Owne - wilder
My Co fission Expires:
* . * * *
Notar as to Owner and
My C.Ilission Expires:
PERMIT FEE: APPROVED:
Zoning
Mechanical
esident
Fire
Building
Plumbing
Address '7 997 A/ t.✓ 7rS
Signature of Contract or Owne_r. Builder
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Phone 7 S^7/- 93 LrT
Ins. Co.
Other
Engineering
Electrical
FENCE SIGN
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6992 NAN 51 Street ° Miami, FL 33166 ° (305) 551-8094