444 NE 100 St (3)Date 61 /DIO(
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 41' n E icoth '• Tax Folio
Legal Description
o er/Lessee / Tenant '{'• 3yv t a 5h1'1 der
tuner's Address 414 (E co
Contracting
Qualifier
State # Municipal #
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle o : : BUILDINN 4 ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Ex ei i 0/ 4 r 4
Square Ft. Estimated Cost (value) •1► ' 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 authorize the above -named contractor to do the stated.
o Contractor or Owner- Builder
of owner and/or Condo • esident Date
_ tis to Owner and/or Condo President
My Cmissioii ExpkA'f � FRREW1 M. N
onm VA° x311 E
o- i, COMMISSION # 0 654213
_ c A M •. e EXPI.ES JUL. 9, 2001
e .0' •i�,y 9 BONDED TI U
N ,O � A TLANTIC BONDING CO INC.
FEES: PERMIT
APPROVED:
Zoning
Mechanical
J
RADON
Building
Pl}u
to
/WO )
C.C.F.
Address
Historically Designated: Yes No
Address
Ph9n
SS#
Competency #
Address
as to Contractor or Owner- Builder
Commission Expires:
Fc. 05'301OF b 3 2 Y7 b 0
' \ D NOTARY - - ( 4 )
Electrical
Master Permit #
-Phone 3SJ 7'57 3 Z
3os- r/s7- 1161, L )
Structural Engineer
Ins. Co.
CYNTHIA SCHNEIDER
My Comm Exp. 10/27/2001
Bonded By Service Ins
No. CC691921
Personally Known I t Other I.O.
BOND
rae.../•-• 10/P1/01
Date
TOTAL DUEe_
N fI 0
Date
ti
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: 41
OWNER'S NAME: J�.k --t. Gnd .hr etd P e r PHONE: '3o515 7 5'12 1
ADDRESS: �1✓ . 100
tr
********************* * * * ** * * * * * * * * * * * * * * * * * *' * * * ...,
ADDRESS OF SITE: 1444, (e iootb Sfi oft.na1 .56x
CONTRACTOR & LICENSE (if applicable) (flegro t3cOne1-1--)
,e
COMPANY NAME: ` etro Ji G 5 PHONE: 35 - 787 $ 11-0
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elementsfgn the site must be listed and indicate the color to be painted.
Walls t‘ G(tl
Fascia
Drip Cap/Drip Edge (,J h : + -
Soffit (i i fe
Roof r\ (k
Flower Bins (\ / 1t
Shutters r1 Pk-
Awnings /A-
Chimney lit-W4"
Doors and door jams (,) h i e-
Garage Doors t Jk i -few
Railings Oh r - Fe-
Fences iI Pc-
Decorative Metal (,k h r-f e
All brick (simulated or regular) (A.)h i 4e-
Stucco Banding (VA
Any other stucco features N
Accessory Buildings IA /pc-
Other
APPROVED:
Building Official Date
J
Rich Cream 68
6837 -1
6837 -1
0
0
•n •
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
ples.
'L'6( 4 4 s
nature of Owner D e ignature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01