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534 NE 102 St (5)- P.E.RMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date b -a� Job Address f34 — X 4 54 - _ Tax Folio 113Z1•201/ 1O C Legal Description f "e 4 7 5,j,idi Master Permit 11 Owner / Lessee / Tenant Owner's Address Contracting Co. 1 X _ 60molf Address Qualifier V( �lCe.J"1" 14IASnhatvyleg_ SS/; CR(q( - State if Competency# CF OoQ a(p°1 *Ins. Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SI WORK DESCRIPTION Square Ft. i%v WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE DO SO MAY RESULT IN YMR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF Y' INTEND TO OBTAIN FL'NANCINM� , 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, a on the attached addendum (if applicable). I certify that all work will be performed to meet t standards of all laws regulating construction in this jurisdiction. I understand that separa 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 we will be done in compliance with all applicable laws regulating construction and zonin Furthermore, I authorize the above -named contractor to do the work stated. Signature of Owner and /or Condo President Date: Estimated Cost Phone Signature of Contractor or Date: PERMIT FEE: APPROVED: Zoning Building��'1` 7 / -To Mechanical Plumbing 'Engineering '751 - O 7l /) .i3e6f le e claw5 OD 0net- Buildr Notary as to Owner and /or Condo President Notary as to Contractor or Owner - Builder My Commission Expires: My Commission Expires: * * * * * * * * �i *0Th 2 TJ LET § _ T © IISec�Il ,� X95. * Fire 0 t h e r FIRU NOTARY PUBLIC UNDERWRITERS.