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MECHANICAL
NAIP(flt shores PkRMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY ( OWNE R TO RETAIN COPY) Job Address Legal Description Owner / Lessee / Tenant Z/9/ � 041 Owner's Address 477 -,/ -2 i5 L.5 7 phone 7:5 98/ 7 Contracting Co. -� % Address ,©257) /ii• 7$ 6 Qualifier / Ll e7 <2a, ,(1J/ SS# �� V c c pie 4 State i (4C 776 Competency # Ins. C¢ 7 Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): /$UILDING WORK DESCRIPTION � ,Q Z Square Ft. Estimated Cost,2 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. 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 will be done in compliance with all applicable laws regulating Furthermore, I authorize t N1 II II IIII // g -named contractor do the Signature of Owner Date: i Mem/1 ee /., 3f .01 ossI0N r4'. i C ' CP T1q • • T��d Et4 o # CC 384336 Jq` %'9:,: °Q1edtte.•OQ.::: "tip •ttit.tck Notary as to Owner and /or My Commission Expires: PERMIT FEE: APPROVED: Zoning Mechanical ELECTRICAL am IS tresident Notary as to My Commission * * * * * Fire Building Address Address Address to Signature Date: Tax Folio Master Permit # PLUMBING MECHANICAL PA FENCE SIGN V r 4 1`7 work accurate and that all work construction and zoning. stated. of ConVadMmg,,or Owner - Builder . Missro • C O �16T A I • p: • }:t cthr of* ner- Builder F 2 F ?ded t�j; o; Q A • amain- Insd�; . Electrical Engineering rds—qzi * I j j 1 I I I I I I I: I. �: .. I I . . . .. I II • • . �; . ; ' . ! ' ': ► i l l 1 I j ! f ! ! ! • 1 { , t , ; ; I i ! ' j t i j: i i —_. — _ I ; ; 1 1 l . i I ■ ; ; I j I I, � de �_ • i i.! � �. : : ,• • i . P r I I CA PA'it'I.i IG ra,rlr, I'a . Sy' acu;:e CON'xRA.CTOR i1`./ml, i.. .. fl SIDENT'AL AIR CONDITIONING CO. Dade 652 -6040 • froward 764 -0409 \ r 1,..V- 4 ( i I ,r ( • c� ' r L 5 - SR/ _