800 NE 98 St (10)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date t " I L `" Job Address *Pi 1 9 S J'r- NV Tax Folio
Legal Description Historically Designated: Yes No
Owner /Lessee / Tenant fw 7 4l 6/Lime Master Permit # '/
Owner's Address ' SC? Pig 'V ,445 I` i 3 31 513i Phone 3 0" 7 4 - V 3 5Y
Contracting Co. (TWP 7-. Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION U F�1K' ` W `d a.
Square Ft. Estimated Cost (value) P
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.
OWNERS 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.
-11 mA,
(6 —cd
Signature of owner and/or Condo President Date Signature of Contractor or Owner- Builder Date
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date
My Commission Expires: My Commission Expires:
FEES: PERMIT 1 RADON C.C.F. ' r11 1 6 NOTARY BOND
APPROVED: TOTAL DUE f3k
Zoning Building el I/ Electrical
Mechanical Plumbing Structural Engineer
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: 9 I6 esDc
OWNER'S NAME: InAR16. j41 PHONE: 3cr 7Q'-/
ADDRESS: l AY - i 8 Sr- dY$V . 3 6 3 f
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: yOz) N. a - '5 Sr 44Sir fl-
CONTRACTOR & LICENSE (if applicable) ove2
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * *c * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls 1 ✓d, y
Fascia £v Vic°
Soffit G✓f+r ere:
Roof N/A.
Flower Bins c a
Shutters
Awnings
Chimney M/4
Doors and door jams tti/
Garage Doors vv/A (wti-r°T )
Railings A1/
Fences /WA-
Decorative Metal Afi-k r
All brick (simulated or regular) NM
Stucco Banding Aifrf -- t
Any other stucco features Abz `rte
Accessory Buildings Ao
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
sample,1
f°'! & - 6(
Signature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED:
r
Building Official
D
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
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