134 NE 102 St (8)p PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
D ate 3- D - b i Job Add i 3 I` / . Tas Folio hi9
1 (hvner/Lessee / Tenant C hi $ h C e L D Master Permit # gs ,"
Knees Address 1 3 Lt Ng ) 0 Z. St /(i4)I1 3 313V $I'ione 3 U c ' �� L/' 3 TO S
ontracting Co. no n e Address
Qualifier Q new
v ✓^
State # Municipal # Competency #
Architect/Engineer Address
Application is • -by 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 perfo �.�*i ■ meet the standards of all laws regulating construction in this jurisdiction tand that separate permits are required for ELECTRICAL
PLUMBIN e S, POOLS, $ • FING and MECHANICAL WORK.
I
Legal Description Historically Designated: Yes No
Bonding Company Address
Mortgagor Address
Permit Type (circle on .: BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ) rt y //v f rf S t„.,2r r.es/mhAl
Square Ft. Z-6
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.)
Signature of owner and/or Condo President
,nl....,
Notary to Owner and/or Condo
My mmission Expires:
FEES: PERMIT O - RADON C.C.F. /[' NOTARY ®� BOND
TOTAL DUE °
APPROVED:
Zoning
at all the foregoing information is accurat
rmore, I authorize the above -named contra
ate
Maria J. Garcia
A. MY COMMISSION # CC839654 EXPIRES
May 25, 2003
n BONDED THRU TROY FAIN INSURANCE, INC
ViSa/
3÷61
Building
Mechanical Plumbing
Date
'Estimated Cost (value) /1
tRib
ntractor or Owner- Builder Date
Electrical
Structural Engineer
ce with all applicable laws regulating
3- 0-so/
Notary as o Contractor of er- alder
My Co ssion Expire, g,,, Maria J. Garcia
=
MY COMMISSION # CC839654 EXPIRES
May 25, 2003
BONDED THRU TROY FAIN INSURANCE INC
DATE:
OWNER'S NAME: Ck, S lur 8c/tows PHONE: 3e(- T Sy- .1oS"
ADDRESS: 13te ►JG- !Dz. S4-
********************************** * * * * * * * * * * * * * * * * * * ** * * * * * * * * * **
ADDRESS OF SITE: 13 tJ 1
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: 6 W (x. PHONE: Pir Th.flY - 3 }b V
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
bevk ► rt NI o w .. 4 3r (f`c Jw pk and km,.
Walls
Fascia
Soffit
Roof
Other
OWNER'
and tha
constru
APPROVED:
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
M A - 0-k g 1,0
M4
N
/44-
Flower Bins 5A Me As Ala �y'e
Shutters spa c-
Awnings SA A
Chimney SA .i ( 4 A Q -
Doors and door jams $4J; L w'i ► T
Garage Doors --- h/1 h
Railings -r i✓1n
Fences i wAr
Decorative Metal
All brick (simulated or regular) M/
Stucco Banding ^/14-.
Any other stucco features w or
Accessory Buildings
FFIDAVIT: I certify that all the fo
e done in compliance wit
I authorize the a
hermore , the p
l
Building Official Date
6
7 6i-44d
1/8
txi
Cn
ng information is accurate
plica. - laws regulating
r, if applicable, to
the attached
ignatur- of Owner Date ' : ature of Contractor Date
* ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Date lP J 1 13 Job Address
Legal Description/0, /Y gDl /
6 . 12,e)/ Lessee / Tenant C 'S4t) 2 1 'jeIIpy✓J Master Permit #k5 5r�
Owner's Address 134 NI E l O 7— sr Phone - q5 1 / -37 67 .
Contracting Co. iLfro/if/ Address
Qualifier SS# - -
State # Municipal # Competency # Ins.Co.
Architect /Engineer
Bonding Company
l�Qus�
Mortgagor
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION - PAINT t4uSE
Square Ft. 2.--J0 Estimated Cost(value) /,97060
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
authori he- ,above -named contractor to do the work stat
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
13ij NC /02 s7
Tax Folio
11.3a #6 /J /5
Phone
Signatur -Owner - Builder
Date :64je9 ..,
� eFfl-I CHURCH
'' 'L /�. � .. t t✓P2.∎ ;AL
Mary 'as to 4 lit ' . ;o+ or ,or • OwnetypBymbde
'
y Commission Ex��. No. CCiJ7645 ;$.."
* * * * * * * * * * * * **
FEES: PERMIT 59 6 ) RADON C.C.F. I' DO NOTARY 5 i DO TOTAL DUE 0,..re9
Fire
' Electrical
Zoning �uildin_ -��'
Mechanical Plumbing Engineering
Other