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1160 NE 91 Terr (8)!Inspection Number: INSP -5609 Inspection Date: 01/10/2006 Inspector: Grande, Claudio Owner: CERAOLO, FRANK Job Address: 1160 91 Terrace NE Project: <NONE> Contractor: Miami Shores Village, FL 33138- Tuesday, January 10, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phope: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: BP2004 -195 Permit Type: Imported Permit Inspection Type: PAINTING Work Classification: Paint Phone Number Parcel Number 1132050010450 Lot: Page 2 of 2 i b 0C° Passed Inspector Comments . Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until !Inspection Number: INSP -5609 Inspection Date: 01/10/2006 Inspector: Grande, Claudio Owner: CERAOLO, FRANK Job Address: 1160 91 Terrace NE Project: <NONE> Contractor: Miami Shores Village, FL 33138- Tuesday, January 10, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phope: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: BP2004 -195 Permit Type: Imported Permit Inspection Type: PAINTING Work Classification: Paint Phone Number Parcel Number 1132050010450 Lot: Page 2 of 2 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 2/13/2004 Applicant: FRANK CERAOLO Owner: CERAOLO FRANK JOB ADDRESS: 1160 NE 91 TERR Contractor Local Phone: Parcel # 1132050010450 Signed: Building Permit Permit Number: BP2004 -195 Contractor's Address: Page 1 of 1 Legal Description: WATERSEDGE PB 9 -141 ELY3OFT OF LOT 20 & ALL LOT 21 & WLY5FT LOT Fees: Description Amount FEE2004 -1542 Building Painting Fee $60.00 FEE2004 -1543 CCF $0.60 FEE2004 -1544 Notary Fee $5.00 FEE2004 -1545 Training and Education Fee $0.20 FEE2004 -1546 Technology Fee $1.50 Total Fees: $67.30 Total Fees: $67.30 Total Receipts: $67.30 Permit Status: APPROVED Permit Expiration: 8/10/2004 Construction Value: $300.00 Work: PAINT EXTERIOR AS AGREED (INSPECTOR) 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: Miami Shores Village 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATI( SE E FBC 2001 L. Permit Type (circle): Job Address (where the work is being done) Is Building Historically Designated YES NO $ Value of Work For this Permit 30 CO Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ ( ' / .S .1 �� , : S (Continued on opposite side) Building D epartment V II doer- ' � 1r; l ti, iLgli Permit No. bP2COLE — 1 C {S . 2€;f'4 ! Master Permit No. Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) FRn�I.;1-, `.r-� Qto Phone # 30S '02 5( Owner's Address 12E) NE Ci9 St Cit M IAM i 5ifoR.E, State FL-- Zip 3 2.341 Tenant/Lessee Name F ( * N . ) . C , E 7 - Q W Phone # 3 0 - 7 6 23 116o N F 9'i jZ City Miami Shores Village County Miami -Dade Zip . 33 �3 $ Contractor's Company Name 3t ) f Phone # S(.: U ABoOE Contractor's Address S Tk /4 (o OE City SA-MC AS A- 8oVEstate FL- Zip 331 Ni" Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: Type of Work: ❑Addition ❑AlterationTew ❑ Repair/Replace ['Demolition Describe Work: rt I KM N Q i C� * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ (C)0 CO CCF $e (C) C.) CO/CC Notary $ S . L r, % Training/Education Fee $ b () Technology Fee $ 1 , E� Scanning $ Radon $ Zoning Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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 $2500, 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. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. The foregoi day o My C. KnrIS` It r J■ i1!'' 48 NOTARY Sign: Print: , My Commission Expires: APPLICATION APPROVED BY: Chc 12/15/03 As identification and who did take an oath. _,,Hips Nuv1Ifl ttf t 5, 2'.i(di Signature Owner or Agent / Contractor strument was acknowledged before me this J �-�The fore oing instrument was acknowledged before me this 200 - c by ��,� 11 , 1R �f✓t3 =.1; , da , 2001, b (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. NOTARY Si --- Print: 1 r .� My Commission Expires: who is personally known to me or who has produced who is personally known to me or who has produced iidentification and who did take an oath. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** FEa 13 **** * * * * * * * * * * * * * * * * * ** a/'//y Plans Examiner Engineer Zoning MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: Z I l 2 -f D L 4 • OWNER'S NAME: 1A IC. C IZ 4oLO PHONE: 3o5-762- ‘54,3 . ADDRESS: 12? iJ 19 6 5r- ) $4 l4-N I S l o 12e5 ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: /16o Jc ?I± 7L PACE MIAMI St oRES CONTRACTOR & LICENSE (if applicable) SELF COMPANY NAME: N IA - PHONE: 305 -7102 - 4.51,•3 ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls ) ` a cr me. V 3z 1.42 1 A 1 kir Fascia 1Ruh At-0t0. e b6.e/ ) M Drip Cap/Drip Edge ----)C' A Soffit nol A i co Roof 3 O . 5 Flower Bins X t ' rn u - , Shutters K L) Awnings Chimney 4l 0 N Doors and door jams „.mi • J Garage Doors X 5c)- ) ■ )1v Railings ) S () - )1,) )1A _ L. Fences N.Y Decorative Metal wU • - . _ m 7R t M coLoR All brick (simulated or regular) ,X 3 i�►`�: .. . Stucco Banding Any other stucco features Accessory Buildings Other Building Official ate 1 / t L144 ature of Owner Date Si u i ature of Contractor Date 4/23/01 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 d • work stated. Furthermore , the paint colors will be as per the attached Si• *: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** N PAINTING IS FINISHED, CALL FOR FINAL INSPECTION MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: c 2 ` I ) 2oo -L- OWNER'S�:? LXakG 0vic'JACJ �, 'e. PHONE: Ros -3-Sb -5 ADDRESS: / I G 0 N E °l 1 s � terra. o ********************************** * * * * * * * * * * * * * * * * * * *** * * * * * * * * ** ADDRESS OF SITE: SS A_.. CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls !\ Fascia 'fie 1rrA Ga r Drip Cap/Drip Edge Soffit V (w t to ) - u c, 6-4 tip Roof Flower Bins Shutters 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 Other T2r va co Trot. r. 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 1 - °' Signature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: Building Official ate WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 ELECTRICAL TYPE, Minimum Fee QTY. TYPF, Dryer QTY. TYPh. Outlet, Appliance Q'I'Y. 'TYPE Service Repair QTY. A/C Central 1 -3 Ton Heating Strips, each Fan Outlet, Wall Service, Temporary - Paint Booth A/C Central 4 -7 Ton Fire Pump Outlet, Switch Piping, Flammable Liquid Signs A/C Central 8 -15 Ton Fixture - Fluorescent Process/Pressure Piping Oven Space Heater (kw) A/C Central 16 -20 Ton Pressure Vessel Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. 'I'YPE Generator QTY. "TYPE Refrigeration, Tons QTY. A/C Central, Tons QTY. Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Pump and Abandon Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Appliance PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE. Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump .Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 2 I MPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. QAv L Print Name Sworn to and subscribed before me this SEAL: 0 FLORIDA, COUNTY OF MI ADE ure of Owner lZ Fo Po u ■.o day of OFFICIAL NOTARY SEAL .\ PR Y Po OFFICIAL A NGELA M BECKER Z ,4- 1 . - n COMMISSION NUMBER - " ¢ IP CC786697 c".. MY SSION EXPIRES ggOl� if ti 9 r Type of Identification Produced: �Lx s3 1., Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION STATE OF FLORIDA, COUNTY OF MIAMI -DADE Personally known OR, Produced Identification Type of Identification Produced: Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY, D • TE Zonin:MZMEIr©A Business Telephone ( u s-) _ '?-t i 3 Fax is Q -. � Electrical Repair Mechanical Demolish Plumbing Relocation of Structure Fire Foundation Only Public Works Add'l Attachment Structural Add'l Detachment Building Official Other PROPERTY QW g 1 o ./ � e_vtaQ. eat ke-r Name 1 Address I IQ CI 1iT A e ri CR. M t 4 1,-14A.• S LtdveA , Fc- 3 3 i 3 k Home Telephone C3 O S ) 4_00 — S - 3- 3 p Business Telephone ( u s-) _ '?-t i 3 Fax is Q -. � TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review ❑ PROOF OF OWNERSHIP (Attach) ❑ FIRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES 0 / V ° ( sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION • ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 1 ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: Address I 1 , 0 0 / ff Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other tleo 9 I >T fe rot ce Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Q Subsidiary Permit No. 8) p ' O� c " / ,Mcats , 5312,e City PERMIT APPLICATION State Zip Description of Work pa 1(-( - c t t; Zoning Linear Feet Square Feet Units Floors Value of Work Tax Assessed/Appraised Value Flood Zone Base Floor Elev. /20 Bldg Value ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Parcel # 1132050010450 Job Address: 1160 NE 91 TERR Fees: Description Amount FEE2002 -578 Building Permit Application Fe$60.00 FEE2002 -579 CCF $0.60 FEE2002 -580 Notary Fee $5.00 Total Fees: $65.60 Permit Status: Approved Permit Expiration: 7/30/2002 Signed: Building Permit Permit Number: BP2002 -197 Printed:2 /1 /2002 Page 1 of 1 Applicant: PAULA XANTHOPOULOU c) Owner: XANTHOPOULOU PAULA Contractor Address: Local Phone: Cellular: Legal Description: WATERSEDGE PB 9 -141 ELY3OFT OF LOT 20 & ALL LOT 21 & WLY5FT LOT Construction Value: $200.00 Work: PAINT FASCIA, FRONT DOOR RAILING TOUCH UP SOFFIT (OWNER BUILDER PERMIT) Total Fees: $65.60 Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. (INSPECTOR) BY: 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. Sianed: (Contractor or Builder) BY: Date 1- 6-9(7 Job Address f /1.6U A../6 f/ /2W Tax Folio // 3azoy 4 &1 3 /,� G J�f T�7► -s L/'6 E Lessee / Tenant � • Sc,4 14 L6SI'/ Master Permit # 3��� Owner's Address / / G D //E ',/ 7 , 7 / 1 _ Phone ( - 3 0 S ) 7 i 7 -:c/ ? _) Contracting Co. 49G0451, Address Qualifier SS# - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Legal Description Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN p WORK DESCRIPTION J , /%^'f6 JFn41L , Square Ft. 7 90 Estimated Cost(value) 0/O 4 Q 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 a applicable laws regulating construction and zoning. Furthermore, I authorize the amed c ntractor to do the work stated. Signature of owner and /or Condo Pfesident Signature of Contractor or Owner- Builder Date: 1/7/0-( ** * APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE No ,knr sup nd / or Coojiliq iirtiyaiedent Notary as to My Commission : ' r 'AMIS8ION NUMBER CC255237 yl F O F � " EXP. * * * * . 261997 Date: Notary as to Contractor or Owner- Builder My Commission Expires: * * * * * * * ** FEES: PERMIT .3J^5U RADON C . C . F . 4e NOTARY TOTAL DUE Fire Other Zoning Buildin 7 electrical Mechanical Plumbing, Engineering