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PT-06-1210PERMIT APPLICATION FOR MIAMI SHORES VILLAGE D ate_,5 fr) ob Address ' �1-' ,�l) L V/-* /�'-f Tax Folio Legal Description 1 /0. t--64" // k 4.)1/ FY- Historically Designated: Yes No / Tenant:Etk 4 1I-4I frid riuS 2, Master Permit # 7, 9 ,r Owner's Address26+ Ale / ec f (hone 3155 -54re — (n C + [ Contractin Co.hoh) Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle on : BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. / 770 41 . fo " , ?° c i r -E / i .4e . 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. OWNERS 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 authorize the above -named contractor to do the work stated. ti gnature of o er and/or Condo President /Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT APPROVED: Zoning RADON 1 =/G Building / stimated Cost (value) My Commission Expires: ■ lk 3 )) /I) otary as t Contractor r Own / /o J ate 1P nY PUB ANGELA ici 3 0"14.:' . 0 2 l r' z :/)„ J.: `:.1;....10)1 4a, 0.1:: O FF\.O y. ' ri• .. C.C.F �C) NOTARY S 00 BOND TOTAL DUE &C t Electrical S4 -e �,�t�►�i Mechanical Plumbing Structural Engineer aft APPROVED: Building Official MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: 3 ' WNER' S NAME : Jj,,,(6;i, 4CDDRESS:��,t0 NE cp-- AV /4- Flower Bins /1/4 - Shutters Awningske Chimney ' �1� Doors and door jams Garage Doors Railings Fences Decorative Metal at ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: Vi(; Ng co- 67(re I CONTRACTOR & LICENSE (if applicable) A) COMPANY NAME: PHONE: - -- ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elem on the site must be listed and indicate the color to be painted. 0 �• Walls � ►e +'1 - Fascias k, b Soffit LJhd -e. Roof ' �/i'1MILii u: - All brick (simulated or regular) ,' /j Stucco Banding . /V/ Any other stucco features /v //9- Accessory Buildings Other 31116 Date t o (dcc ) ; i /496 OWNER'S AFFIDAVIT: I certify that all the fc and that all work will be done in compliance witl construction and zoning. I authorize the above-1 do the work stated. Furthermore , the paint colo s pies. a 11i) / . ./ . /l .11 1 Q S/ nature o ' Owner ate Signature of Contractor Date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address 4 C A/ 4 / ST Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant J Tom' F 1 A � F- Master Permit # C�Q,4o Owner's Address (! /® 7 1 C" f Al C 6 4 1/(=! A - rd Phone Contracting Co. Cr W 4 e=. Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION fit ,�` ✓. r1 % e r<Ja CIS E'_ ✓) Square Ft. Estimated Cost (value)(6 V 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 authorize the above - contractor to do the work stated. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: ignature of Contractor or Oevner- Builder . „00( PO, ANOLAND ALTIERPOLANCO COMMISSION # CC 451720 r lull Q EXPIRES MAY 6,1999�,; BON DEOTHRU Notary :9fb ` ortlF P My Commission Expires: FEES: PERMIT 0,40 RADON C. - o ‘O NOTARY BOND TOTAL DUE lfQ APPROVED: Zoning Mechanical Plumbing ✓ ' / Engineering Electrical L Date 18 Aug 92 Job Address PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 420 N.E. 91 Street Tax Folio 11 3206 019 0070 4 Legal Description East 1/2 Lot 11 & West 47.5 feet Lot 10 Block 1 ELPORTAL 9/101 Dade County Owner / Lessee / Tenant Robert Lewin Master Permit #��6' /� Owner's Address 420 N.E 91 Street Miami Shores, FL 33138 Phone 754 5441 Contracting Co. Owner providing labor & material Address, Qualifier SS# - - State # Municipal # Competency # Architect /Engineer Address Bonding Company Address_ Mortgagor N/A Address Signature of owner and /or Condo President S`i Date: APPROVED: Fire Zoning Buildin Mechanical Plumbing_ Date: Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION Pressure clean roof, exterior walls & trim and paint same. Pnnf to hP painted white. Walls painted as per attached sample. Trim painted white Square Ft. Estimated Cost(value) 1,000.00 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 accurate and that all work will be done in compliance with all applicable laws regulating co'. ruc ion and zoning. Fu h-rmore, I authorize the above -named contractor to do the work stated . ontractor or Owner -.0 Notary as to Owner and /or Condo President Notary as to Contractor or Owner-Builder My Commission Expires: My Commission Expires: - K ** * * * * * * * * * * * * * * * ** FEES: PERMIT 3 96 RADON C.C.F. 1 ■ 5-- NOTARY TOTAL DUE J ?PO Other Electrical Engineering ................ ................. C1S? Inspection Date: 06/28/2006 Inspector: Grande, Claudio Owner: HOLMES, JUDITH Job Address: 420 91 Street NE Project: <NONE> Contractor: HOME OWNER Building Department Comments Wednesday, June 28, 2006 Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Paint Inspection Type: Final Work Classification: Repair Phone Number (305)342 -4733 Parcel Number 1132060190070 Lot: Page 1 of 2 Passed Inspector Comments !� Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until ................ ................. C1S? Inspection Date: 06/28/2006 Inspector: Grande, Claudio Owner: HOLMES, JUDITH Job Address: 420 91 Street NE Project: <NONE> Contractor: HOME OWNER Building Department Comments Wednesday, June 28, 2006 Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Paint Inspection Type: Final Work Classification: Repair Phone Number (305)342 -4733 Parcel Number 1132060190070 Lot: Page 1 of 2 Miami Shores Village men.( \ Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 S I ( Z ��� Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIVED MAY 0 9 ?00 A Permit Type (circle).-_BuildingT) Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) 4 k1 )k V Q S Phone # 306 ` , ; j�,�- Owner's Address � C » (� (1.1 S ((C� City � f ), Ib.L `��k�' ✓�5 State Zip p ✓S BUILDING PERMIT APPLICATIO FBC 2004 Tenant/Lessee Name Job Address (where the work is being done) , „5 - (7 ,' yoz State Certificate or Registration No. Architect/Engineer's Name (if applicable) Type of Work: ❑Addition ❑Alteration I Describe Work: I i0 r 4 -)6 , r 4 i rk Phone # a<5 r )c) -e Permit No. 1 T 5- - Z Master Permit No. City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO }C Contractor's Company Name J . (� _ f-I Phone # Contractor's Address City State Zip Qualifier Name Phone # ['New Certificate of Competency No. Phone # Value of Work For this Permit $ 21 ( 'Square / Linear Footage Of Work: ❑ Repair/Replace ❑ Demolition ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * ** **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ � Permit Fee $ CCI� CO /CC Notary $ raining/Education Fee $ Z Technology Fee $ ( -� Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ & See Reverse side -* 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. Signature Sign: Print: (Revised 02/08/06) My Commission Expires: �d iftCK >QZ Owner or Agent The forego • I instrument was acknowledged before me this' day of flay , 20O` by (cue A,,,,t )7.46. who is personally known to me or who has produced 17, 15 1 1( • As identification and who did take an oath. NOTARY PUBLIC: Sr: Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 , by who is personally known to me or who has produced as identification and who did take an oath. MONICA USSETH DIAZ ah IA MY COMMISSinti # co 483995 EXPIRES: October20, 2009 * ***c •• Bonded Thru Notary Public u fs WPM NOTARY PUBLIC: Sign: Print: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Plans Examiner Engineer Zoning Date 5 a i .U0 Owner's Name j ids. t Y l trvl2 S C rr Owner's Address 4c)- E (622-1- City . S • State I; L Job Address (where the work is being done) sa- rn- City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted ©r ry\ ple_ Walls Fascia 1 Drip Cap /drip Edge `��`` —� Soffit /,c9k Roof t 111. i-\ --- e- Flower bins fd1 l Shutters r0 Awnings Chimney Signa Doors and door jams Garage doors 4 Miami Shores Village Paint Color Approval and Agreement Railings /AVM Fences hi / 1 Decorative metal /t//79 All brick (simulated or regular) A//�} Stucco banding N / fr Any other stucco features /v // Accessory Buildings Al / /+ Phone # g,t 5- 3 f - 4 Zip S3 g 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. APP TION APPROVED BY: l Date Date chc 6/18/03 Issue Date: 5/26/2006 Owner's Name: JUDITH HOLMES Permit Type: Paint Work Classification: Repair Job Address: 420 91 Street NE Comments: EXTERIOR PAINTING Additional Information • Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores Village, FL 33138- Building Department File Copy Applicant Signature Permit Expires: 11/05/2006 Contractor(s) Phone Primary Contractor HOME OWNER Yes Type of Work: Exterior Color: IVORY SAMPLER Additional Info: Classification: Residential 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PT -5 -06 -1210 Phone: (305)342 -4733 1132060190070 Lot: PB: Total Square Feet: 0 Total Valuation: $ 200.00 Required Inspections Final Fees Due CCF Education Surcharge Notary Fee Permit Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $60.00 $1.50 $67.30 Invoice Number PT -5 -06 -24761 Total: Amt Due $67.30 Amt Paid $67.30 $67.30 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.