1099 NE 97 St (3)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
Job Address
Legal Description 7
Owner / Lessee
Owner's Address
Contracting Co.
Qualifier SS# - - phone
State #
Architect /Engineer
Bonding Company
Mortgagor
j 6Qi 1QE 7 - nR
A/7H -
/ Tenant l
SQL
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION Q� ' t Q� -* e- e,
ir _e„LsDA., v co-Gt.,ck
Square Ft. Estimated Cost j Q o
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 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.
C],
Signature of Owner and /or Condo President (Signature of Contractor or Owner - Builder
Date: (J Date:
Nota r as o Owner and/or. OTA PUBLIC. A E O FLORIDA Notary as to Contractor or Owner - Builder
My •mmission ExpiresMy Commission Expires:
* * * : �9Y COMM4SION EXP ,ES APRIL 4 1992
CMIUJU HRU STEM®EE M 7S & MET
PERMIT FEE: APPROVED: Fire Other
P4 ‘ , 1 16
Zoning Building
Mechanical
(OWNER TO RETAIN COPY)
Competency #
rJ
c
Address
Address
Address
Address
E 'k )09)
Tax Folio, Sao j 7 7 5
# ��Q'� •
phone 6q- o
Master Permit
Ins. Co.
Electrical
Plumbing Engineering