685 NE 97 StPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date c1-25-q, Job Address V35 ( E c 1
Legal Description /9-� /c t2 /, . ' 6 " ,l 0.49' Master Permit # 3 l q 2
Owner / Lessee / Tenant M l
Owner's Address
Contracting Co. PC sErT l �q
Qualifier ?A lmond 3411((10101 u
Square Ft. 3C, 125
ignature
Date:
No/ry .s
My Commiss
* . *
PERMIT FEE:
tap
HBO �J
Vi5 Ne `1') ST
of,Owner and /or Condo President
to Owner an. or Condo President
ion Expires: SC *p_,
APPROVED:
Zoning
Mechanical
*
Fire
Building
Plumbing
Tax Folio // 32T /7 )i
Phone
- TS y -L4y 14
Address 505 wok.) I O sT.
SS# Phone C 5) 151 -1100
State# Competency# Ins. Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): B G - EL PLUMBING MECHANIC PAVING FENCE SIGN
g
WORK DESCRIPTION 1 c,n� urn i I j I O
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 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 informai i accurate and that all work
will be done in compliance with all applicable laws
,�
Furthermore, I authorize the above -named contractor to co/ " ork stated.
atu
Date:
Electrical
Engineering
Contractor or Owner - Builder
_ �. ��,�• q 20 of
Notary.e.s to Ccntractcr '.r Owner -Buil er
My Commission Expires:
* * * £tWRT %C S":41. 1. ri.O "9
tONQSS1oN F)P. K°•R.7c','s`i..)
41001At. I $ . OA..
FLORIDA
DRIVER LICENSE
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