795 NE 97 St (8)Date - 46.i Job Address 9
Legal Description ® / e'
00rt / Lessee / Tenant C � 4 ' y
795 /1/.6. 9? -17- s:
Sign
Dat
owner' Address
Contracting Co.
Square Ft. Estimated Cost(value
APPROVED:
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
re of pwner and
Zoning
ndo President
Mechanical Plumbing
Tax Polio // ic;W /"I" 2` W
Master Permit Tf 2 c
Phone
Address
Qualifier OU/1/40/ SS# - - Phone
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
3IORK DESCRIPTION / V1/ 7 t XT , /OE_
„20o. op
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 im
on the attached addendum (if applicable). I certify that al
standards of all laws regulating construction in this jurisc,.c
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, R &+
indicated above, and
performed to meet the
erstand that separate
HANICAL 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
au the above -named contractor to do the work stated.
Signature of Contractor or Owner- Builder
Date:
Notar /as td Owner and /or Condo President Notary as to Contractor or Owner- Builder
My Commission Expires: NOTARY PUBLIC. STATE OF FLORIDA My Commission Expires:
MY COMMISSION EXPIRES APRIL 16, 1992
csMelf) TRRU STEMBIER -ADAMS & SWEET
** * * * * * * * * * * * * *
FEES: PERMITS / ° -5 RADON C.C.F. G® NOTARY .W TOTAL DUE / /g 9/1'
Fire ® Other
Building ./ /'Electrical
Engineering