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BP2005-1343Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building --SEP� jj Permit No.eSPCE5 - ,(�j413 Permit No. Mechanical Roofing Owner's Name (Fee Simple Titleholder) Can si,tnei M . Fu dq a Phone # gag 751, 2 73'1 Owner's Address 16.S td.4r. 101 City State Zip 331! Tenant/Lessee Name N 014 E Phone # Job Address (where the work is being done) t 6 3 N • %u . %Ot x r STICBE i City Miami Shores Village County Miami -Dade Zip 33150 Is Building Historically Designated YES NO Contractor's Company Name Phone # Contractor's Address State Zip State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit C:3� . Oct Square Footage Of Work: Type of Work: ❑Addition ❑Alteration [-]New Pfl Repair/Replace El Demolition Describe Work: Ci-e4a"-2omF CI.EA.wh Flsakuaey Pw1mrr Doolt :•.�«..•,+..••��.++��:/._��+n..Fees::��+��.��..+��+.••��..«..�� Submittal Fee $� Permit Fee $ l V CCF $ �• L CO/CC Notary$Jr �1r� . W Training/Education Fee $ 0 • ZO Technology Fee $ I ' Scanning $ Radon Code Enforcement Total Fee Now Due $ 46-7' (Continued on opposite side) Zoning Bond Structural Plan Review.$ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding 52500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued /n the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signatureswnnee (r or AA 1 1 ,, Ogent Signature Contractor The foregoing instrument was acknowledged before me this 4 The foregoing instrument was acknowledged before me this day of SE5P 20C�" by J Oh n P4ff—A--- day of , 20 _, by who is Pte I t`alxknown to me or who has produced who is personally known to me or who has produced identification and who did 0011.:il Sign: i Print: L7e— My Co m " sion Expires: as identification and who did take an oath. Abel VajAaTARYPUBLIC: lissionM1)172319k OS- -Jul13 200- Sign. Bonded'rhrn iel3"J°'-c'n Inc Print:_ My Commission Expires: ################################################################# APPLICATION APPROVED BY: U01, chc 05/13/03 ############################## yt /0 r, Plans Examiner Engineer Zoning Miami Shores Village Paint Color Approval and Agreement Date Owner's Name C&A ;71 . Phone # 3-5 75b - 2737 Owner's Address 1 63 . • 1Of City Mlatwst SrMrtcS State Ft-e�ea Zip -�31 5) Job Address (where the work is being done) 1 6 3 M w 1 O 1 { Srn> City Miami Shores Villaee _ County Miami -Dade Zip 331 SO Is Building Historically Designated YES NO V" Contractor's Company Natne (if applicable) Walls Fascia Drip Cap/drip Soffit Roof Flower bins Awnings Chimney Doors and door jams Garage doors Railings Fences Decorative metal All brick (simulated or regular) Stucco banding Any other stucco features _ Accessory Buildings - Phone # A des a Other 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. Date 9/16110.3r Owner or Agent v � Date al O � Am,i--ATIONr A-PPROVED BY: P _ Jtiic:a. ciic 6119/e7 Miami Shores Village ' paint Color Approval and Agreement Date Owner's Name "" FuL- PhoneTM 309 IS& 2797 Owner's Address tia ta-W. O Citv rAIAeft St+ORGS State F1-ott.pr+ Zip aRlso Job Address (where the work is being done) 1 to 3 N W 1 O 1 s+ STILRa i City Miami Shores Villaee County Miami -Dade Zip 331500 Is Building Historically Designated YES (dNO Contractor's Company Name applicable) Phone # All elements on the site must be listed and indicate the color to be painted Fascia Drip Cap/drip Edge Soffit Flower Awnings Chimney Doors and door jams_ Garage doors Railings Fences Decorative metal All brick (simulated or Stucco banding Any other stucco features Accessory A es as — Other 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. r Date 9&t/Vt) Signature dila� Owner or Agent Date APPL,lCATIOhr APPROVED BY: rL Dfii-ia. cnc 6118/01 Miami Shores Village 10050 NE 2nd Avenue Phone:305-795-2204 Printed: 9/22/2005 Applicant: CONSTANCE Owner: FULGO JOB ADDRESS: 163 Contractor Local Phone: Parcel # 1131010230150 Fees: FEE2005-12669 FEE2005-12670 FEE2005-12671 FEE2005-12672 FEE2005-12673 NW 101 Building Permit Permit Number: BP2005-1343 FULGO CONSTANCE ST Contractor's Address: Page 1 of 1 Legal Description: BONMAR PK ADD A RE -SUB PB 24-71 LOT 15 & W1/2 OF LOT 14 Building Painting Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: $60.00 $0.60 $5.00 $0.20 $1.50 $67.30 Permit Status: APPROVED Permit Expiration: 3/13/2006 Construction Value: $600.00 Work: PAINT DOOR Signed: (INSPECTOR) Total Fees: $67.30 Total Receipts: $0.00 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BLK 2