1201 NE 96 St (7)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
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Legal Description/% / Master Permit . 4 /
Lessee / Tenant (11(7 _ ('
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Owner's Address ,j/ 4' 6 51- o ( ui /` Stc)(f:-
Contracting Co. 0
Qualifier
State# Competency#
PERMIT FEE: APPROVED:
Zoning
Mechanical
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SS# - - phone
Address
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
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WORK DESCRIPTION L // ( - 6( I i d l a_ 1 lit /lit �E_(� p �?G� / Okle
e
Square Ft. Estimated Cost
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.
Signature of Owner and /or Condo President Signature of Contractor or Owner - Builder
Date:
Date:
Notary as to Owner and /or Condo President Notary as to Contractor or Owner - Builder
My Commission Expires: My Commission Expires:
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Fire Other
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Plumbing Engineering
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Ins. Co.
Electrical