PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address/ 86 0 A/61:57; Tax Folio
Legal Description � Historically Designated: Yes No
Owner/Lessee / Tenany ///// / '/� / Y � 7 / Master Permit # qqoi
i CrAdie Owner's Address Phone x 3e 1 /70 ,9
Contracting Co D d W0476 Address 3 Lt / t j Q D
Qualifier SS# Phone
State #
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one):_UILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. Estimated Cost (value) 25
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYIING 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 compli
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President
My Commission Expires:
Zoning at
0
Municipal # Competency #
Address
Address
Date
a
of
.�.: ■ice � -� =��
//
YS I VILLAR
"'A.RY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR. 1 002
Notary to Contractor
My C ,mmission Expire
C.C.F. / • L v NOTARY 35
FEES: PERMIT RADON
APPROVED: ...�. .5)QI
Building
ontractor or Owner- Builder
Electrical
Mechanical Plumbing Structural Engineer
BOND
Ins. Co.
TOTAL DUE
//4iS"a2 .24 fr3
S— —
icable laws regulating
Date
� r �
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE V
OWNER'S NAME: ," V / /.3 9 02/
ADDRESS; -
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:.
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls frt.
Fascia Gt/i`re7
Drip Cap /Drip Edge p
Soffit Ai ie'
Roof
Flower Bins
Shutters
Awnings
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
OWNER'S AFFIDAVIT: I certify that all he 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. urthermore , the paint colors will be as per the attached
samp
APPROVED:
Building Of cial
_57--z/-07
-07
5 �7//
Date
Ins= X70 2/97
60P tar c gig
Signature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01