PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ‘,/.?S /m/ Job Address NE 99 ST Tax Folio
Legal Description Historically Designated: Yes No
CQwn / Tenant 4 I),'rAF CK L Master Permit # 17 933(7
Ownees Address /v a. 41/ #q- � Phone C75 SO 0
Contracting Co.�/ QwN L Address
Qualifier !! SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company
Mortgagor Address
Permit Type (circle one
WORK DESCRIPTION
Square Ft. 3�0
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
A t a u I t r- C'LErN I F d— C.t. 0 . 014-1 /U -T
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.
Signature of o ' t
and/or Condo Pr
No . :: to Owner an or Condo o m)t� Date Notary as to Contractor or Owner- Builder Date
My ommission Exp' v;ARY PUBLIC STATE OP FLORIDA My Commission Expires:
COMIvi1SSION NO. CC714103
MY COMMISSION EXP. MAR. 1,2002
FEES: PERMIT
RADON
Address
Estimated Cost (value) 1 7v 0
Signature of Contractor or Owner- Builder Date
^
C.C.F. ' A V NOTARY ) BOND
APPROVED: TOTAL DUE
Zoning 0 f"' 0 Building Electrical
Mechanical Plumbing
Structural Engineer
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: 6
APPROVED:
(
OWNER'S NAME: co< PHONE: �
ADDRESS)/ Q - G' i ;� ►-Purr ... , 33 r
* * * * * * * * * * * * * * ** v7i 9v*vc ******** ********** *************
ADDRESS OF SITE: `iq g-
CONTRACTOR & LICENSE (if applicable) N A
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls C,a 4-AviF _12E - MG gae 45
Fascia
Drip Cap/Drip Edge �, r , li d . --
Soffit,
Roof CLEY1Y4 < -eV Ly
Flower Bins
Shutters 4,- )14 -r-re
Awnings L,,, t
Chimney
Doors and door jams W(-t-t-rG
Garage Doors
Railings
Fences
Decorative Metal l..314 - re
All brick (simulated or regular) 3" c-fc
Stucco Banding
Any other stucco features vk
Accessory Buildings
Other
En
ro
Bavarian Creme • 20W 71/156
0
r
0
t
Building Official Date 4/23/01
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
sampl
r'i/v" 1 � 1 A.10/
ignature of Owner r ate Signature of Contractor Date
* * * * * * * * * * * * * * * * * * * * * * * ** ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Y og-
a WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
/272 / V e W3) Tax Folio 1 Z5 ON20
1 _
T
n p 2 - //o a2 . .�d/ 7 ak? C/KC6 ei✓ s
/ Lessee / Tenant l" ALI LI,
Date Job Address
Legal Description
Ft.
Co.
** * * * *
FEES: PERMIT '1 O
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
owner (nJ n / Pkozaj Master Permit #
/V
Owner's Address L � E �� � ��Q P hone 5-d) 25 - ' -3
1 FR Qtc gzo Add s a N /24 s'( /V/1 . FC3 3r�
Signature o ew a f ondo President
Date:
Notary as to Owner .nd /or Condo President
My Commission Expires:*
Fire
Zoning Buildini
Mechanical Plumbing
Contracting /'
Qualifier SS# - (- Phone, ' '4�-' 4 L1 - 5 L
State # Municipal' ° ‘ Competency # f 3 5-q -
o / � ( Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHA ROOFING PAVING FENCE SIGN
WORK DESCRIPTION IA))) 1/F - /�' .Pv.P,(.ly� YX0?Uif.f�92
11Y PU OFFICIAL NOTARY SEAL
2 ( . 7 /-6 BARBARA ANN FUGAZZI
fc * COMMISSION NUMBER*
N " CC360191
MY COMMISSION EXIR.
� `� F F MA.FC .C24
4
Estimated Cost(value) / z- 7,
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 construgtion and zoning. Furthermore, I
authorize the above-named contractor to do the work stated. 1'
Signature
Date:
Notary as to
My Commission Expires:
PHILIP A. LOEWE
_.; ., .1 MY cantons / CC 278067
* EIPIiE1 May 7.191
g.',.. Thu Notary Pao Undee t u d
0QJOTARY J � UCH TOTAL DUE f d �C
7' *
actor or Owner- Builder
or or Owner -Bui
26241f
der
**
Other
Electrical
Engineering