30 NE 95 St (7)PERMIT APPLICATION FOR MIAMI
Date 4 10 -l" Job Address . 30 'NE ‘157"" ax Folio _
Legal Description
Owner/Lessee / Tenant /1D K/5 + 9 . JJ .
Owner's Address
Contracting Co. 06., /VER _ - Address _
Qualifier
FEES: PERMIT
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State # Municipal # Competency #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL l0
PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN /
WORK DESCRIPTION 1 / NA 7 ,L/ k ,4 /i : N AtI6e- � '/n • I h'J 5 ' al h
a 49; CD
Square Ft. Estimated Cost (value
081
Colonial CGeuin (90)
"0/ s ( ' 0A ) 6 1 =
305 Antique
White (90)
C.C.F. SOD NOTARY 4) o BOND
TOTAL DUE 45 600
018
Regal Green (88)
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.
Signature of owner and/or Condo President Date r atur of Contractor or Owner - Builder Date
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Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date
My Commission Expires: My Commission Expires:
e- 530- 5yC- 1 7- ?c3 - CID
APPROVED:
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Zoning Building
art/ 4 / b 1 a Electrical
Mechanical Plumbing Engineering
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