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PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 0/ 7 /59 9 Job Address ?6 Tax Folio Legal Description Historically Designated: Yes No ,vg, Owner/Lessee / Tenant' Owner's Address vto /ye Contracting Co.' .4 Se L. r Qualifier State # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): WORK DESCRIPTION t Fekiti / /y `V/ eiA [ 6s'e° 'EIS Address .onl Municipal # Notary as to Owner and/or Condo President Date Address Phone}( Master Permit # Mouse ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN 4 2 4 �� \ : ,OE CDR a7 r ve Ski o rrS t Fc (SC c c, h,6 and S Fecevr owe Square Ft. Estimated Cost (value)4 5 ©© 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 AP 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. =ear Signature of owner and/or Condo President Date Signa a bf Con or or Owner -Buil 7; Date Notary as to Contractor or Owner- Builder Date My Commission Expires: My C ssio . x pir p�g�.�oT� (, e_ 8 0 . ° V 1 n/7 * 'i` ^ i OOMYSSON Nunn "'Tr . a CC797277 7 1. ' Q' MY CO.MS$ ON EXPIRES OF r.. DEC. 17 2002 FEES: PERMIT ,...5O, RADON C.C.F. • 60 NOTARY .5 BOND APPROVED: TOTAL DUE ,c":1-2. �'' Zoning Building 0---32717 111 Electrical Mechanical Plumbing Structural Engineer D