PAINTMIAMI SHORES VILLAGE N
BUILDING DEPARTMENT G
305- 795 -2204
Buil.ing Inspection Request
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Date 2. 0
Type lnsp' n FP /J '4 L PA—c
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Permit No. P Od 4/— T l 7
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Name ( s 7)6 ( CAk( l-)
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Address
Company
Phone #
Correction
Inspection Date
Re- Insp'n Fee ❑
Building Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2004 -477
Printed: 4/9/2004
Applicant: LUIS DEL CANTO
Owner: DEL CANTO LUIS
JOB ADDRESS: 1015 NE 93 ST
Contractor
Local Phone:
Parcel # 1132050150050
Contractor's Address:
Page 1 of 1
Legal Description: BELVIDERE PARK PB 16 -71 LOTS 9 & 10 BLK 2 LOT SIZE 100.000 X 113 OR
Fees: Description Amount
FEE2004 -3763 Building Painting Fee $60.00
FEE2004 -3764 CCF $0.60
FEE2004 -3765 Notary Fee $5.00
FEE2004 -3766 Training and Education Fee $0.20
FEE2004 -3767 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $67.30
Total Receipts: $67.30
Permit Status: APPROVED Permit Expiration: 10/5/2004 Construction Value: $120.00
Work: EXTERIOR PAINTING
Signed: (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:
BUILDING
PERMIT APPLICATION
FBC 2001
Contractor's Company Name
Contractor's Address
$ Value of Work For this Permit
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): ( Building // Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) /4, d J � n 70 Phone # �S?t . 7 ,3
Owner's Address / 0 /.S^ ?7 (= 9. /
City /4/ fi► State �_ Zip `' .. / P
Tenant/Lessee Name -- Phone # —
Job Address (where the work is being done) S Ge. ea b a if -L
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
City State Zip
Qualifier
Architect/Engineer's Name (if applicable) Phone #
I 26.°°
Type of Work: ❑Addition ❑Alteration ENew ❑ Repair/Replace
ID Demolition
Describe Work: Q a-c k7 1 i1 C
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ 60 . DO CCF $ • (OO CO /CC
Notary $ 6.0C) Training/Education Fee $ • 2.0 Technology Fee $ 1 . 50
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
G7.30 cc
An o 8 2004
Square Footage Of Work:
Phone #
oo es, .,
Permit No. ( h e 2004 - 4 7 7
Master Permit No.
rZ°
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.
NOTARY
Sign:
Print:
My Commission Expires:
Chc 12/15/03
Owner or Agent J �( Contractor
trument was ac wledged before me this (� The foregoing instrument was acknowledged before me this
20 Oct, by C � t Pry' rt /mil ay of , 20 _ , by
known to me or who has produced D � J -who is personally to me or who has
The fore
day of
who is personally kn p p y p roduced
APPLICATION APPROVED BY:
As identification and who did take an oath.
Signature
cY OTARY PUBLIC:
om n #DD231984 Sign
: *: xnires: 13. 007
Print:
Atlantic Bonding Co., Inc.
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
*************************************************************;,;.*********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
a-P47. .F 0 V
My Commission Expires:
as identification and who did take an oath.
APR v 8BO
Plans Examiner
Engineer
Zoning
, Miami Shores Village
Paint Color Approval and Agreement
Date — S -0 ti •
Owner's Name L- U-:- a/21 64 11 Phone # 3 - 717 7 y
Owner's Address ( O /,/- 77 v 9� ‘'
City ../ if?3 State Zip /3
Job Address (where the work is being done)
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
Walls C a..)-7-1.truy-10-- a/ (/ 3- T / 0
Fascia ‘1-°'.-.) Pr )- (:'/ 0— yL 0
Drip Cap /drip Edge
Soffit "—
Roof
APPLICATION APPROVED BY:
Signature
er or Agent
Moonlight White 21 -60
Flower bins
Shutters
Awnings
Chimney C 0-7Y" )1
Doors and door jams i V 1 I( w / �3
Garage doors y''`''rah4(( -ht (- 0 - �'- 2- a R () - le 0
Railings d
Fences
Decorative metal
All brick (simulated or regular)
Stucco banding f°' )1 ) ( ((
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.
Camouflage 2143 - 40
Date y 6 T
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