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PAINTSquare Ft. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date _ Q 17� C� V \ ) ob Address 17N__. 4 Tax Folio )1 5D6 /2 S Ol P Legal P tion /'7 °' al Descri I t5 &, in gc U / / ( Own' ) / Lessee / Tenant � (-2 ��� \}- (-.) l -e blurn(); �� Master Permit 31 Owner's Address \\--1 j 9(6 Phone 7s)-) (-,c(_- Contracting Co. /.q/' X, Address Qualifier SS# - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): B ILDING, ELECTRICAL PLUMBING CHANICAL ROOFING PAVING FENCE SIGN II WORK DESCRIPTION C1 ��� � ( JVI`, ( L), ) 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 Bove -named contractor to do the work stated. c),!\},■1 )1)— Signatu e of owner and /or Condo President Date: 9/AO/f Not as !Eo Owner My C mmission Expi �Fr (Ar' undo President c `-< Estimated Cost(value) ) ( Signature of Contractor or Owner- Builder Date: Notary as to Contractor or Owner- Builder My Commission Expires: ** * * * * * * * * * * * * * * * ** FEES: PERMIT A C RADON C.C.F. ? -,0 NOTARY 3 --1 / 12 TOTAL DUE ✓' ©v APPROVED: Fire / Other Zoning :uildin: � Electrical Mechanical Plumbing Engineering iri PERMIT APPLICATION FOR MIAMI SHORES VILLAGE q Date b Address 1, 9) Tax Folio •r Legal Description 1 No / Owner/Lessee / Tenant `l 1 r Master Permit # ! / 7 K ., Owner's Address Phone 7Sy co5c63 Contracting Co. WORK DESCRIPTION storically Designated: Yes Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Mortgagor Address Address Address Permit Type (circle one): BUILDING ELECT CAL PLUMBING MEC CAL ROOFING PAVING FENCE SIGN Q4 / OrCL)( . Square Ft. Estimated Cost (value) 9c> WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR LMPROVEMENTS 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 -n. contr • to do the work stated. Signature of owner and/or Condo President Date Signature of Contractor or Owner- Builder Notary as to Owner and/or Condo President Date My Commission Expires: My Commission Expires: Notary as to Contractor or Owner - Builder Date Date FEES: PERMIT �t� RADON C.C.F. ` � NOTARY J BOND TOTAL DUE `/,�• ,ed APPROVED: Zoning Building tift3 Electrical Mechanical Plumbing Engineering