PAINTDate
Legal Description
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
J Address
s 1 4mTh'°
Owner/Lessee / Tenants" 1 C Ch� v f —
Owner's Address a As A/ , / , ( 4 Phone)( 3 -4qCe 1 a 7—
Contracting CV FeS:i
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle o ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Address
Address
WORK DESCRIPTIOJ €Kk --(Or tAb T�Cn
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
APPROVED:
Zoning
Mechanical
RADON
746
-) E 94p- Folio �) 3 ;O 0/3
Historically Designated: Yes No
Address
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 OF 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.
OWNERS 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 therk stated.
S'
•
0
L Ilk
I
A
OF F‘.' NOV. 15,2002
OFFICIAL NOTARY SEAL
ANGELA M BECKER
C; COMMISSION NUMBER
Q CC786697
4.••• MY COMMISSION EXPIRES
3
D
ature of Co
o Mary . I o Con
My Commission
tra
Master Permit #
Or or er-Builder Lt a1
C.C.F. ' v NOTARY 5, BOND
TOTAL DUE ,h 5
Date
Building Electrical
Plumbing Structural Engineer
MIAMI SHORES VILLAGE
Pint Color Approval and Agreement
DATE:)( JJCL-4-05 (J D.) CO '-
OWNER' S NAME: ZCP s1 PHONE. o . 413,, - 49
ADDRESS'/
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: S' 04 C . c
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to
Walls w iLo f P.E` $ -ea p-em'u,rr'R'u4
Fascia 1 11
Drip Cap/Drip Edge r /
Soffit \N) .�
Roof J.S I)-
Flower Bins (Pr
Shutters 1j A
Awnings Pr-
Chimney
Doors and doof jams ..15/Pr
Garage Doors , >S /. - "
Railings �► /,
Fences
N\)
Decorative Metal
All brick (simulated or regular) r De q 4 n p•-
Stucco Banding N / A
Any other stucco features N h
Accessory Buildings
�
Other — p l
r/ 0 n rV S i e Q� f h- hl V1� omc --
pcz nQ 1 s Dar ^
¢do P b
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate 1
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 colors will be as per the attached
same es. S Z 0
cz -e— c O � --�
/i of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
513/0/
Building • fficial Date
4/23/01