PAINTINGDate / 7/14/% q Job Address id /iL Fgai W 14 ' Tax' o / / &24060/309a7)
Legal Description / A # 4 /0 v // 0/0cic_ , Historically Designated: Yes Owner/Lessee / Tenant U� - ' f v � Master Permit # (o)
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Owner's Address Phone
Contracting Co. Ocur e r Address
Qualifier 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
WORK DESCRIPTION 1 ) k /U dv fair,
tAgA . .44-k,
-�-. t .t-� H l re T„,
Square Ft. Estimated Cost (value)
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 irk will be done in compliance with all applicable laws regulgting
construction and zoning. Furthermore, I authorize the above -named contractor to do the w
Signature of owner and/or
My Commission Expires:
FEES: PERMIT 1 /0 I RADON
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
President Date
Notary as to Owner and/or Condo President Date
,',
Notary as to Contractor 4 er- Builder
My Commission Expires:
FIO L 7'
O
4 1 i? 7 7 '7
/e/'31--
60o
TOTAL DUE 4/...C.1 .6 U
APPROVED:
Zoning Building ) V f 41(r Electrical
Mechanical Plumbing Structural Engineer
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
BUILDING MIAMI SHORES VILLAGE, FLORIDA
PLUMBING 0 PERMIT N_ 452i3
ROOFING 0
OW n ev
I 0 f• // BI. 7
10 /1/4-PE q 8 S1i*e e 7 -
w t#
t9
K
n11 04 j3ay G+xe1 2'4
/ / 3,7-C�6 to13 li
Subdi-
vision /1 -S /
Sq. Ft.:
Value of
Project $ btP ,
Date A_ 3
19
Contractor's
License No.
Work to be performed under this Permit E )(ten r 4.'!'i /1t )ri 3
/2e wti-i ie. 70 w1 / 7e
>> o5 -- ' 7S ` f 3 7 0
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion berefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time If the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon•
sibility fkr work done by his agents, servants or emplo s.
y / I
Signed • (INSPECTOR) BY
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations /
pertaining theret• nd ja str conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this p t _ass responsibility for all work done by either, myself, my agent, servant or employee.
/
TRA or BUILDER BY. AUTHORITY
)io7Qfi
a skacl
Permit: 4 6ea
CCF: f7
Notary: r—
Bond:
Radon:
Amount of S –
Permit: ' l0&