460 NE 95 St (9)Date K/ Job Address
Legal Description '' !- Sod� sfre,A A
/Owner Lessee / Tenant 2c44 . C/1'62(4,')
Owner's Address
Contracting Co.
Qualifier
State#
Architect /Engineer
Bonding Company
Mortgagor
ign . ;.tire of Owner and
Date:
All it 4
No , y s to Owner and /or Co do President
My' ommission Expires:/Y/0 f
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PERMIT FEE:
IIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
/ O A/E 9.. S 7
.c60 %vim 9_N 57 — .
Competency#
S S#
Plumbing
Address
Address
Address
Address
3 3/ 32 Phone
Tax Fol is /if 106 74 0$/
Master Permit #
Phone
Ins. Co.
Permit Type (circle one BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION 04f5-2 ( /
Square Ft. 7Vo 0 Estimated Cost , c7tO 0
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.
r Condo President Signature of Contractor or Owner - Builder
Date:
Notary as to Contractor or Owner - Builder
My Commission Expires:
* * * * *
APPROVED: Fire Oth
Zoning Building Z- , Electrical
Mechanical
Engineering
f/5 S'
7s, 03/.-
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