PAINT• PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 3- � I - O / Job Address y b9S 1) � g t1 5 . Tax Folio
Legal Description Historically Designated: ��pp
/ Tenant Master Permit # Ta
Owner's Address J t � Phoney,
Contracting 1Y1� .' ,� Address i97 e/C/1(l%tt/!1
Qualifier
Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor
Permit Type (circle one) : UILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION X 'Pm l- ,lb/L.. (16 t UvS�.
APPROVED:
'er
-nical
an' / r Condo President
t l n 0 6P I
Notary as to Old er and/or Condo President ate
My Commission Expi ,„IINIp ' �, Luz Albaran
* ' Y M" COMMISSION # CC703192 EXPIRES
Dedbmber 14 2001
, a,) ' d BONDE TROY f INSURANCE,
FEES: PE RADON
Date
C.C.F.
Address
Yes
Square Ft. Estimated Cost (value)x A 7 0 , oo
i
WARNING TO OWNER: OU 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, POOLa, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all ork will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do thek stated.
3//d1
Building
Siafiatui'e oI Cot(tractor or Owrief- Brtilder
Notary as t
My Commissi
111
0 NOTARY 0
ntractor or Owner- Builder
Electrical
rest Luz Albaran
MY COMMISSION # CC703192 EXPIRES
December 14 2001
BONDED THRU TROY MANN INSURANCE INC
No
BOND
TOTAL DUE
,QZ/ g °
Plumbing Structural Engineer
a
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE:)`) - 5 a
OWNER'S NAME: ,M +« K; , t tt t PHONE:
ADDRESS: Y1S Ac
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54
ADDRESS OF SITE:
CONTRACTOR & LICENSE (i p 1i ab1 )
COMPANY NAME: �v�jg,�f M iQ,, n � PHONE
* * * * * * * * * * * * * * * * * * * * * * * * *
*** * * * *c * * * * * * * * * * * * * * * * * * * * * * * * **
sap. .les.
Signature of Owner ate
APPRCVED:
3
Building • ` cial Date
All Elements on the site must be listed and indicate the color to be painted.
Walls HC -2
Fascia HC- 1 ,R
Soffit jJL-ia„
Roof
Flower Fins
Shutters 0 9 3
Awnings Nift
Chimney \//
Doors ar d door jams a 23
Garage Doors HO, -- I Z
Railings
Fences
Decorative Metal
All brick (simulated or regular) He �
Stucco Banding N(A-
Any other stucco features alk
Accesso:y Buildings
Other (�(
0
Si _n. u = of Contractor ►� ate
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 color will be as per the at .ched
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
O/
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