777 NE 98 St (2)Date 3' O. 01 Job d `? 7 7 ,ij. . Tax Folio
Legal Description 2M Historically Designated:
Owner's Address
Contracting Co.
Qualifier
WORK DESCRIPTION
OWNERS AFFIDAVIT: I certify that all the
construction and zoning. Furthegnore, I a
Signature of owner and/or Condo Presid
hattily Y/ / ! of
N O as to Owner .(�� ident Dat
y i
My Comr sien &xpirrs•
FEES: PERMIT
APPROVED:
Zoning
Mechanical
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/ T e n a n t M1 i / 4 1 2 5 - Dk tS 91.(i --- Pki - t r(d-
oP
LOURDES V. MARTINET
My Comm Exp. 8/20 /2003
No. CC 858221
7( Known I 1 Other I.O.
v 0 RADON
Plumbing
3/121 -
Date
SS#
State # Municipal # –3c/.1565 Competency #
Address
Address
.3 0IY
Yes No
Master Permit # — 1 —)3 d b d
Phone (305) f `:( t99;
Address 6 &41V P 6 coo ti SE
Square Ft. Estimated Cost (value) 1,7`75. 1 0
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
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.
information is accurate and that all work will be done in compliance with all applicable laws regulating
above -named contractor to do the work stated.
J l o)-6 / O
Building
ontracto or •
f�
ture of Contra
tary as to
My Commission
Electrical
Structural Engineer
3- 0, - 0/
er- Builder ^ ', to
'
uilder Date
OFFICIAL NOTARY S CAL
.' OFP ANGELA M BECaER
Z O ^i ,_ �' coaeimsVON PRIMER
)
-•• r77 CC786697
gl Q
• 0 � ." OAY No 5, 2 002
f�
l
l-
C.C.F. D NOTARY S. n () BOND /
TOTAL DUEL 6
Signa
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: 3 • oq • 0 (
OWNER'S NAME: MK */LffS �ii-y- PHONE: o '426
ADDRESS: '7 7 7 NI. E . Q ST
* * * * * ** :************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: 1 14 • C.
CONTRACTOR & LICENSE (if a licable) q`f 5500„2/
COMPANY NAME: j44f-n PHONE: 757 -7/
********************************** * * * * * * * * * * * * * * * * **: * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
?/ 9.2J-
4 2z
Walls
Fascia
Soffit
Roof
Flower Bins
Shutters
Awnings
Chimney
Doors and door jams v1k�
Garage Doors Mk-r>%
Railings
Fences
Decorative Metal
All brick (simulated or - egular
Stucco Banding k
Any other stucco featu es
Accessory Buildings
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 ste.urthermore , the paint,10 s will be .. s per the attached
samples. r -
311,101
Date
****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
APPROVED:
j b/ /
Building Official Date
CA/tae MCC
htd
Signature of Contr or Date
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION