535 NE 95 St (8)t Date d3 f j319 0 ,Job Address
Legal Description L ®7 /7 „44 /�/‘ A6,G' 4 / 4.4504,14e, Z
Lessee / Tenant th A4 T4/944M0N.IO Master Permit #
, Owner's Address , C °,fr r , 9 5 Phone
• Contracting Co. L ur '. 2. 74 yLC Co Address /321/ NW sa S7,e-ca `.
Qualifier / SS# - - Phone 7o'g WS
State 1k Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
• WORK DESCRIPTION
Square Ft. .Estimated Cost(value)
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, ROOPING and MECHANICAL WORK.
0 " 'S AFFIDAVIT: I •ertify that all the foregoing information is accurate and that all work will
be in compliance ith all applicable .laws regulating construction and zoning. Furthermore, I
aut ••ize the E1'o med contractor to do the work stated
Si
Dat
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
APPROVED:
3 /q v
5 . 3 6 - A E 95 S7ZE 7 Tax Folio // 324 , 4 073®.f
r and /or Condo President
l "Ffi Ate/ Al or-' fR" O DF '7Zc)
NKtary as to Owner /and /or Condo..P.residen„,,.,.,,,,
My Commission Expires: NOTARY PUBLIC SLATE SF FNMA
MY COMMISSION EXP Alf bi►Ifg
** * * * . * HUED T GEN I11f? 4 * i * *
u , .,_ r,,...... 1
FEES: PERMIT 3 RADON C.C.F. , � NOTARY
Fire
Zoning Building
Mechanical Plumbing
so.°°
tary as to Contr= tor or Owner - Builder
My Commission Ex•ires:
NOTARY PUBLIC SLATE Of CURIO ,`
MY CONNISSION EXP Jff IE •Ii
* * PROD TWO 8iENER4I DIF• I" 4
~� y TOTAL DUE 3/4V
Other
Electrical
Engineering