810 NE 91 Terr (9)Building Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2005 -571
Printed: 5/11/2005
Applicant: VIVIAN HANES
Owner: HANES VIVIAN
JOB ADDRESS: 810 NE 91 TERR
Contractor
Local Phone:
Parcel # 1132060050380
Work: PAINT
Signed:
(INSPECTOR)
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 10/17/2005 Construction Value: $100.00
Page 1 of 1
Legal Description: GOLDEN GATE PARK ADDN PB 6 -130 LOT 12 & W1/2 LOT 11 BLK 3 LOT SIZE
Fees: Description Amount
FEE2005 -5869 Building Painting Fee $60.00
FEE2005 -5870 CCF $0.60
FEE2005 -5871 Notary Fee $5.00
FEE2005 -5872 Training and Education Fee $0.20
FEE2005 -5873 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $67.30
Total Receipts: $67.30
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:
MI SH RES 5I G
BUILDING DEPARTMENT
305- 795 -2204 OCT 1 8 2
Building Inspection Request
Date 1 0
Type Insp'n rikkt 131 T
Permit No. V Lcos 5 7-f
Name
Address
Approved
Correction
Re -Insp' n Fee
BI0 ME Q1TT0v
Company 01APV
�
Phone # 1t (30 ` ' (Zoj
Inspection Date 101(1105
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/11/2005
Applicant: VIVIAN HANES
Owner: HANES VIVIAN
JOB ADDRESS: 810 NE 91 TERR
Contractor
Local Phone:
Parcel # 1132060050380
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2005 -571
Contractor's Address:
Page 1 of 1
Legal Description: GOLDEN GATE PARK ADDN PB 6 -130 LOT 12 & W1/2 LOT 11 BLK 3 LOT SIZE
Fees: Description Amount
FEE2005 -5869 Building Painting Fee $60.00
FEE2005 -5870 CCF $0.60
FEE2005 -5871 Notary Fee $5.00
FEE2005 -5872 Training and Education Fee $0.20
FEE2005 -5873 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $67.30
Total Receipts: $67.30
Permit Status: APPROVED Permit Expiration: 10/17/2005 Construction Value: $100.00
Work: PAINT
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:
•
7 l'
Contractor's Company Name
( onlractor's Address
S Value of Work For this Permit
nIto
bu•
4729ke
11 /1.1d1111 1_1(.).
Building Department
1005(1 N.E.2nd Avenue. Miami Shores, Florida 33138
Tel: (3051'4 x8972
L.
ccsone
MO.
�C73C�
(K6()
etrical
r••
Slate Zia
Qualifier
Permit No. f2,90 S - ] 1
_.. .Mister Permit No.
Plumbing Mechanical
Phone # 3Cs./. 75'9 -C765
L'2CR C.cZ
Zip 73)79
WFS Phone #
(0 ct( .)'( GZC�
County Miami -Dade Zip
Is Building Historically Designated YES \ NO
Ph one #
Square Footage Of Work:
33135
Roofing
Stale Certificale or Registration No. Certificate of Competency No.
Architect /Engineer's Name (if applicable) Phone #
'type of Work: EAddition A / ❑Alteration t(e)1 ❑New 'D Repair/Replace ❑ Demolition
Describe Work: ! � M / F,ee \i Or L 110' PA CIA
* * * ** * * ** *** * * * * ** * * * * * * * *** F ees s * * * * * * * * * ** * * * ** ** * ** * ** * * ****
Submittal Fee 5 Permit Fee S ou - 00 CCF 5 t CO O CO/CC
Notary 55 .C)(,) Training /Education Fee 5 c O' ) Technology Fee 5 1 -` 0
Scanning 5 Radon 5 Zoning Bond 5
ocic. Enforcement S Structural Plan Review. 5
_12ol
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip • 4#
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certi /ied copy of the recorded notice of commencement must be posted al the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signatur1 tj� ? T ,;„a Sigmautre
Owner or Agent Contractor
The foregoing instrument was acknowledged before
�p me this LO The foregoing instrument was acknowledged before rue this
v L
day of \ , 20 , by V v i Oil Orel �) , day of , 20 , by
who is personally lcu n to me or who has produced I __ J • who is personally known to me or who has produced
Cho 05/13/03
As identification and who did take rl o� h. as identification and who did lake an oath.
NOTARY PUB � I ° NOTARY PUBLIC:
********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
9 , A /4. ------
Sigh:
Sign:
,... , out u og ra: e7 ,
Print: :-,,,0 Y•119$. Print:
My Commission Expires: b &u ' ,to, ie . mo
°� , My Commission Expires:
* * * * * * * * * * * * * * *Yr * * * * * ** **iii .' ***** *i** **** 9* Yr 3c*` tc ***************** ic************* * * * * * * * * *YC * * * * * * * * **Y: * *k:F *,:
'* 4******* * ** *** ** **4 *** ***4*4 ** * * * * 4 4.1
APR 2 8 205
Plans Exaunincr
Engineer
Zoniq
• 1 •
Miami Shores Village
Paint Color Approval and Agreement
Date / I �
t
Owner's Name * v 1 V t Ct v\ 1 ( " � � �_ ^
Owner's Address S 0 A r -( ° terra
City 0`kA7 1 4, t c( O(e-L State
X /6 x' Pr (-
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name (if applicable)
Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elemepts.oid'the site must be listed and indicate the color to be painted
Walls
Fascia v4i'111 ? -
Drip Cap /drip Edge
(t) KA
Soffit (KAUJ
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
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
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.
Signature
APPLICATION APPROVED BY:
Owner or Agent
Phone # � � � (/' it( ,
Zip
Zip
Attach Color Samples
With Numbers
Date
Data
chc 6/18/03