32660 (2)PERMIT APPLICATION FOR MUNICIPALITIES' OF DADE COUNTY
4f r
r (OWNER TO RETAIN COPY)'
Date? Job Address 44 G V Tax Folio / ( . f 6 b II/ Iii / r
Legal Description / /1).9.4,4,, tL / `lid 6 Jas 2-"
Owner / Lessee / Tenant o �!
`'. _ : % ��, , L. �:;/ / /;. . Mas ter Perm � � e�.� �C-' e
Qualifier
State #
APPROVED:
atoti.4,/
Zoning
Owner's Address A i >1 �j/ ` of�' 5 4
� ! Y � .Phone % 7 {� �/
Contracting Co. Address
SS#
'Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGt
WORK DESCRIPTION "0 l , - - k1/7-2
Square Ft. Estimated Cost (value) r kg/ 1201 dro
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DC
SO hAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENT
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING VAN
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, an
on the attached addendum (if applicable). I certify that all work will be performed to meet th
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 wil,
be don 1x compliance i all applicable laws regulating construction and zoning. Furthermore,
oath • ' ize the a contractor to do the work stated.
Signature •f owner and /or Condo President Signature of Contractor or Owner- Builder
e: f47 a, i
Notary as to Owner and /or Condo Pre iAen, Notary as to Contractor or Owner - Builder
1�g Commission Expires: 1zYP uuLI u w OF FLORIDA � My Commission Expires:
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NO r
MY COMMISSION EXPIRES 5/09194
Bonded ihru Stria-Adair & Sweep
� * * * * * ; * e * * * * *e
FRES : PERMIT 1 ' t "' ` Q RADON C . C . F . )4);6 , NOTARY it TOTAL DUE Iii (55
Fire
- Phone
Date:
Mechanical Plumbing Engineering
Other
2' Electrical
30 DAY TEMPORARY- ELECTRIC SERVICE (continue)
lee t4.1 k rRMD'1 , being first duly sworn,
depose and say that I am the Electrical tontractor for the above described property and that the electrical installations as
now existing will not create a safety hazard if temporary - service is connected.
Sworn and subscribed before me this /
day of iige,e
Notary Public, State of Florida at Large
My commission expires:
I. C. e C � r 140 , being fast duly sworn,
depose and said I am the Building Contractor of the above described property and that I will not permit occupancy
of this building until final division obtained and that I have the authority insofar as the owner of said property is
concerned to prohibit occupancy until such final inspections are obtained.
Sworn and subscribed before me this /
day of /9/ , r
Notary Public, State of Florida at Large
My Commission Espies:
Man J. Smith
MY COMMISSION 0 (x459074 EXPIRES
May 3. 1999
BONDED THRU 'TROY FAM INiAte .DiC.
Mom J. Sm
MY COMMISSION i C0459074 EXPIRES
May 3, 1999
at MID TWO TROY FAIN DIORAMA Ire.
Page 2 of 2
SI
ATURE OF
TARY PUBLIC
Release to FLORIDA POWER & LIGI IT CO.
Date: / / 7? 7, by: ( nave) J-•/ kid �� , I `OeY 5
Date: :�. ,- p,
To: (name)