821 NE 99 St (8)vdc-Pc
; PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
,�.:.., • S�w � 'C.C.- 3 3 /3 � r
01 Job Address e2 / /V 9 9 Tax Folio
LOT 15 0 4JEST 'it..aFCo+ 16 10 8K ►65
Legal Description S .1 2) - 0 , Se c. - e ,c . w, .to - storically Designated: Yes No
Owner/Lessee / Tenant e• C t C E ,..r.-06-2.c::.,
1..
Date -7 /
Square Ft. oC , 'goo
Estimated Cost (value)
Master Permit #
Owner's Address e 21 14 , C 41 Si- . Phone \ 0 s J -T C 1- 1663
Contracting Co. U k *..? p �A t i I N 6N 1AC 'QZeJ 3 I Adcss 1 I. k a % CAV4 C I. 1 - 1 L
Qualifier V \ c_ TO €- 0- V A C.D SS# -� - �� `� Phone � 1
c c
State # Municipal #$O — $Zt Y1 Competency # 00 0 3' 0 3 Ins. Co. Ar• CJ3 J?
Architect/Engineer r' A Address
Bonding Company ('r Address
Mortgagor 0 1 Amt Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 1 tJ 7 1J E E R-• 0 Q--- t}' r o ®-F tiJ A 1 -6Q -t 0
o
e-?
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 AFFIDA r : I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction an o g. Furtherm., ; authorize the above -named contractor to do w.rk s . ed.
e of owner
o President D
V1 rYr@nrrxo��ii�
- = � .
Notary ;� r.: QrC i i I S510N q
My Co I• , ,' Ban d e dT r ES:AaPdc U Underwriter::
FEES: PERMIT
.,, n d�, �:, # C27495
EXPIRES: March 24, 2002
, , Bonded Thru Notary public Underwriters
No . as to C
My Commissi
/ '®
RADON C.C.F ( NOTARY •' '^ BOND
APPROVED: TOTAL DUE (D
Date
Zoning O/ - 0 // 5101 of Building Electrical
Mechanical Plumbing Structural Engineer
�
01
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE': '7 e a r
OWNER'S NAME: ..•rtdvc, w a-5-- 7/-
PHONE: 3 5- /a G 3
ADDRESS: '2-/ /1/ a // -� i J'c 333
*********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: SA. « c ki
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: \ J t , ` R 0 (TN, O 1 i i 1 - ) C 1 , , PHONE: ( mo o S) . 7 Q 6 -f 9 4-0 -
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elemen on the site must be listed and indicate the color to be painted.
Walls 11 PR- t tce_
Fascia
Drip Cap/Drip Edge W s, •
Soffit
Roof 1N;
Flower Bins
Shutters C"ea?o .,a - koQ� ` ' J `"
Awnings ji / •
Chimney
Doors and door jams
Garage Doors
Railings
Fences
Decorative Metal
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory Buildings
Other
APPROVED:
i )L j )
Building Official te
lMOt �6
4.
fY "
k I
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, p
do the wor Fu • hermore , th- paint colors will •1 as pe e a tac e
sample . 1 t / /- ....,
Signatu of Contractor Da t�
** * * * * * * * * * * * * * * * * * * * * * * * * * * *1 * **
WHEN PAINTING IS FINISHED
CALL FOR FINAL INSPECTI('j
43/01
0
q.
le(
�1 7
Date 7 Zfi 7S Job Address
Legal Description 40v3t
Owner / Lessee / Tenant UJ/cei/ L i 'I R. • . Master Permit #
Owner's Address '
Contracting Co. C C' ! c Address /o/ 4�� /7 9S7
( 40 —
e UeR q V f � d -y .
Qualifier/-e��- /�iv,8�S4� -
State # Municipal it 2 3/y2 - ompetency # /1 3 S' Ins.Co. 4' S
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDI ! ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Pt. Estimated Cost(value) 6 co,
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
amed ntractor to do the work stated.
,,, a
sident
auth e the a
Signature of owner and /%'r Condo Pr
Date:
Notary as to Owner and /or Condo President
My Commission Expires CFI'iC3 ETi' At''CSL,1u
/�
KA.': iii LYNN viOEILIA
NOTARY PUJ 1t' 7`: E. E .A FLORIDA
C: .. 4 ::
* my fig P. iti:ry .2,1593
** * * *
3/$. RADON
APPROVED:
FEES: PERMIT
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
C.9 DAD NOT c:'
C.C.F.
Fire
Buildin
Tax Folio
Mechanical Plumbing
NOTARY TOTAL DUE
Engineering
.0////
Signature of Contractor or Owner-Bu der
Date: 4
.3 77a?
4 ' a- 7r
3 77x?
Phone 1 S Y ‘ o
otary as to Con : pr•i► er
i
Nt.) I ' . I 1
My Commission Ex
►i.res ART .ENE W6iAVERLINC
NOTARY I'U3L1C STAW, O'' FLORIDA
COMMISSION NO. CC390429
* * ICY -(...s MIS SIO { EXP. SEyWI' 20,1998 *
Other
Electrical