576 NE 97 St (8)Date
Legal
Contracting
Qualifier
State#
(own52/ Lessee
Owner's Address
Description
Job
Architect /Engineer
Bonding Company
Mortgagor
ON FOR MUNICIPALITIES OF DADE COUNTY
Address
8 -e, � / & G ./J 4}
Sigr,Aturb ox Owner and /or Condo President
Date:
4 i . ./441 /
Ni ary /d 3 to Owner and /or C
My Commission Expires: � //4
* *
PERMIT FEE: APPROVED:
oning
Mechanical
(OWNER TO RETAIN COPY)
5-7d 17
/ Tenant 0004 L. r A ,/
S77 A2E97
Co. f70Bf /7 /1) (
NV /57 ,J 00/V3/97
Address
ss vg -2 tl -J&2
Competency# /60E?
Address
Address
Address
Master Permit
Phone
/00/ G0 04ti,94- RD AVi91T2
Phone
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION 1)11E65 W »ND f /Air 4m ''T 7f /ii1
CU1 L!- 5 T& Cn t oic 6i9-41744
Square Ft. Estimated Cost ?o v
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 laws regulating construction and zoning.
Furthermore, I authorize the above -named contractor to do the work stated.
do President
Fire
Building
Plumbing
Tax Folid/ L n2 j ) 9/T /e 17
✓ / 7
Ins. Co. ('¢-HEJ9T" ,TL-/ os6L)c
( 201 ' 04j - 0
Signature of Contractor or wner- B uild`►,•r
Date: 9... 3- 7/
otary /as to Contractor or Ow er- Builder
y Commission Expires: !1 /4
* * *
Othe
Electrical
Engineering
r J &5 - . 9J 6 7 ! .z
o
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