1200 NE 97 St (13)■ �►,
PERMIT APP FOR MIAMI SHORES VILLAGE
Date /. o��° Oa Job Address / 2OO !Y • C N . L Tax Folio g �� `l f i (i (Jr
Legal Description ppit/f- EX'rav D,..
/ Tenant f (i(IQ 4 /1/6 Z / /S
Owner's Address /0700 /1! • e. 97 7*
Contracting Co. t ' tJ
Sao nt'T Fh
Qualifier °lei) 6 Y (5L0 Lid y
State # . ( 0- Municipal # 9/42..5 3 3
Architect/Engineer Address
Bonding Company
Signa e of o — er and/or Condo President
Notary as to
My Commissi
er and/or Cond.'(' esident
es: s
C • WIGS
raptres Joss 34. NOS
Bonded nes
AL uella Bonitng Oo , but.
FEES: PERMIT ; () RADON
� 2
Building
Date
C.C.F.
Historically Designated: Yes
SS#
Phone
Address 64 mdy AA/6n 0 RCP -
Phone 3e S / — 7t
Competency # 7 /4' Ins. Co. 21111144
Address
Master Permit #
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION »d k /NIA /
Square Ft. Estimated Cost (value) 0 4p
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 aws regulating
constructio , d zoning. Furthermore, I authorize the above -named contractor to do the work stated.
(A 3/
S
.r 1 er -Bui 4er _. . liaise
e4;5'.1 p OFFICIAL NOW U t L
v e ! ANGELA M. 010: .:3:_A
1(E1 '0 2
MMAIt dtiti P_zpiFit:S ,
NOV, 'y st,t3t `
/
4 - 1L1.1. /JP,
of Con � V or er- B .
�r
r
• r: • as to 1 • ntracto
My Commission Ex
AP 3CO;)- igi
No
Retia
/• 2/- 02,
Date
APPROVED:
Zoning
Mechanical Plumbing Structural Engineer
�°� Electrical
° MIAMI SHORES VILLAGE
DATE: 1. 2 `(. 0 Z
OWNER'S NAME: �R gL PHONE: '1S(- &
ADDRESS: (2 alp n(. L im. Q7
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: / t o , . E 7
CONTRACTOR & LIC NSE (if applicable) q 5 00 -t t°4-
COMPANY NAME: ( v NI-r aril I S PHONE o �( —7
Sco
* * * * **
s.p pies.
�� !
Ar
S
APPROVED:
Paint Color Approval and Agreement
/ /Oa1
Building Off -'ial Date
All Elements on the site must be listed and indicate the color to be painted.
Walls 6x, port
Fascia ,4J
Drip Cap/Drip Edge
Soffit /p 7 2
Roof ,4-
Flower Bins
Shutters
Awnings
Chimney
Doors and door j
Garage Doors
Railings
Fences
Decorative Meta
All brick (simulated or regular) /
Stucco Banding
Any other stucco fea
Accessory Buildings
Other / AG E th r- ; i Y j ®n( &) L 0407 5 -E5
AO "NIP CAP e ovrizy ED1 IS(
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. I authorize the above -named contractor, if applicable, to
do the,work stated. Furthermore , the paint col ill be as per t attached
gy-/
1/5
1072
H
cn
nature of Owner ate Signature of Contractor Dafe
***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
FOR
Al
TO THE . g
PAY fil
ORDER OF__ _ atki- — sei
fcc,
VISCOUNT PAINTING AND DECORATING
Bank of America,
ACH FUT 063100277
16/1/Alh
Look for: blue backgojund on the front'of thig check, and the imagoSaf6 e. logoltni bnekt:IfttOkpresentrdo not easU'
ta
1$6
27 aTh 7 - 37T:t
1979 1 1:
5l- OA 6 63-27/631 FL
DATE
( - 0 0 __ DOLLARS
Oa. elb.
WO .440
0 4063002??4 003602267r