600 NE 98 StPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
"CO
Date --3 / Job Address
Legal Description /HY
Owner / Lessee / Tenant jq/l7,70A -S
Owner's Address
Contracting Co.
Qua1ifie
State i Competency # 6�� l Ins. Co. �/`- t/(..
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one):
'WORK DESCRIPTION - /-/36P? /
ignature of Ognr
ate: STATE Of FL
Ev7 /11/
NOED
MRMIT FEE: APPROVED:
Zoning
Mechanical
BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
/D/
Square Ft. .�6o Estimated Cost /oU
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO
DO SO MAX RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU
LNTEN) TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
2ECORDING YOUR NOTICE OF COMMENCEMENT) .
.pplication is hereby made to obtain a permit to do work and installation as indicated above, and
)n the attached addendum (if applicable). I certify that all work will be performed to meet the
tandards of all laws regulating construction in this jurisdiction. I understand that separate
'emits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work.
WNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work
"ill be done in compliance with all applicable la ulating construction and zoning.
urthermore, I authorize the above -named contractor t• the work stated.
Condo President
Th
ptary as to Owner and/ r Condo Preside
y Commission Expires:
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Phone
7 /(r„CP / 41 7.2 "'
Fire
Building
lambing
Address
Tax Folio // ✓ Z t1 /7//W/
Master Permit # J/167
SS # / - Phone gva as 0-0
Dat
re o ot Wt
or Owner- Builder
STATE OF FL
My /±'
44 0/49 z � ED
otary as to Cont ; or or Owner- Builder
My Commission Expi es:
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alL0i1(,71w
Other
Electrical
Engineering
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