576 NE 97 St (2)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address �,� Tax Folio //3 /7 /57.0 O
Legal Description 427 />6 d/ 1P 1iLS.S Master Permit # —VP/
Owner / Lessee / Tenant M, f 1 Pl/AA- Kee L
Owner's Address _67 M t 97 ra ✓ phone ,2
Contracting Co. &,Ye)g7' •/fi27, / - 7e, Address / /c.50 / Ad/"
Qualifier / /'`l La,e7 ge, of dh SSii •
/ - - 9°''q
State # Competency # / & We/ Ins . Co .
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION
e ig/N 1 'P'7
Square Ft. Estimated Cost c r.349 1 .,
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 constr ction and zoning.
Furthermore, I authorize the above -named contractor to t e ;,ork stated
ire•, CJ a-LictAJ
G - e- Jj Lt) aLd,J
Signature of Owner and /or Condo President
Date:
Signature of Contractor or Owner - Builder
Date:
N
arias to Owner and /or Condo President N ary as to Cont ac or or ner- Builder
My Commission Expires:L/J6 /9�'J My Commission Expires: /1/40/7g
* * * * * * * * * * * * * *
PERMIT FEE: APPROVED: Fire
Zoning Buildingq*
Mechanical Plumbing Engineering
I
Other
91 Electrical