PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date (' Z2. Ot Job Address \, (03Z g0 • Tax Folio
Legal Description
Historically Designated: Yes No
Address
Master Permit # /g2 22
Owner/Lessee / Tenant) 0\ •J • f;[L, Ct-biatvcit
Owner's Address (03A (� � . �`'. Phone
Contracting Co. k F.. , n }- . "4? a 1 S .. 1 1. 7 z,. C.
Qualifier S. �r r s SS# Phone 3 ac $ 4 v 7 3
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
305 7S 6b8
S ` s
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION pre 5S u rc c: l a.-- .t._ ,p ,�.3e 4j-• �.I
Square Ft. Estimated Cost (value) O 0 0. 0 0
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.
Owne" ; `451dflfttgident • : • jF IC STATE 01: 1.:>i', i %,'
COMMISSION NO. CC
COMMN;10N EXP. MAR. 1 002
. IS
/ /
gnature
own
Notary
My
FEES: PERMIT J O J RADON
APPROVED:
Zoning
Mechanical
/_ —
d/or Condo President I)a�
DOD -zZ2,- f�
Building
Date
C.C.F. '
folol
Signature of
03
actor or Owner- Builder
Sir 78y-62. 'D
/L)
Notary a o Contr
My C
ssion Ea pires: GLADYS J VILLAR
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR. 1
NOTARY S BOND
Electrical
(.2.Ic,
4 t , e
0
z2.--o/
Date
Plumbing Structural Engineer
•
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATER ' 2Z' cQ 1
APPROVED:
t///441
Building 1' ficial Date
PHONE" 30.x1 ( 6G g.Z
OWNER'S NAME: • . - . ► w f-li
ADDRESSE 03 1.9 - ''- sr. Utaii.,A
* * * * * * ** ************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE' 1032 0<c
CONTRACTOR & LICENSE (if applicable) 9 5 X3'5 vo z 3 o
COMPANY NAME: P, ,., -: y e , ��, �y., PHONE 3 ��-- S 4 4o - 1 3'{ £
***************: P* *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls 4vci LCD-))
Fascia L
Soffit
Roof N 1 a
Flower Bins u„.,-11
Shutters L�- t .�i�
Awnings N 1
Chimney N 111
ovG isSo�
Doors and door jams
Garage Doors ,. c.a. > ,�.,, w
Railings tV 1 Ft Lancaster White 78
Fences N j
Decorative Metal la,C0i5 .c.-, C "'
All brick (simulated or regular) s► t v + "'
Stucco Banding v> tl
Any other stucco features ∎ l t 4
Accessory Buildings U l p,
Other
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. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will be as per the attached
samples.
1
Signature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Date / /29/9 Z Job Address / N) G . 9BSr. Tax Folio // -90gD5 4Ve A
i /.s • < , /
Legal Description i�i.7 /MSiOii:►.:iii . �% i I,.
/ Lessee / Tenant1 ;9MEN f , 4/E3SE t Master Permit #1•
Owner's Address 1032 Iv ` E . `Z g .s-t , Mil /_ ,0 03/23 751-209A
Contracting Co. Address
Qualifier°
Square Ft. PDO
OWNER'S AFFIDAVIT: I certify
be done in compliance wit
au orize the ab named
AIM f
I gnaturp
te: 7 90
own
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
SS#
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address OIrCe
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION P4),4t ' EX f X F 00St
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.
�/ �� riot typ or stamp
44 ^'K Ye k „ Y Public
tar as to -Owner and / or G� 8 4 t1� k _ =p oduced I,D
My Commission Expires: Ype an 1 °umber Induced:
❑ DID take an oath o
yr -DID NOT rice an oak.
** * * * * ( *
FEES: PERMIT-17 3 0 RADON C.C.F.
APPROVED:
Zonin
Mechanical
that all the foregoing information is accurate and that all work will
,•1166411' regula ing construction and zoning. Furthermore, I
mk elated .
My Commune Epp. AA M NN
0 : No. CC197515
Fire
Plumbing_
- - Phone
Estimated Cost(value)
Signature of Contractor or Owner- Builder
Date:
Notary as to Contractor or Owner- Builder
My Commission Expires:
* * * * * * **
NOTARY - TOTAL DUE k 1-19P
Other
it" Electrical
Engineering