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PAINT PERMITCONTRACTOR Names �r %�� LicenNp 7 7,1 - .3 evoreeve,0 teoeif Address de 0 Ahg / / W fZ AM-444 i //� 1 4C/ �C. o3d' /4 t3 Telei,rt: f a 75 Fy 90� .0375L Quali PROPERT OWNER (hr' ie �, / � ` WW Names �r %�� ° ( e lz Address /0 gi ' ®%`.16424)2-4 Home Telephone 7s7-Jz,9 Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Add'l Attachment Foundation Only Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. (51) Address: 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 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 /t 70 ,4 9� "' " ."t az24, 7./ Address Apt. City State Zip /� ' Description of Work (i./a2 PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Zoning Linear Feet Square Feet Units Floors Value of Work co Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Master Permit No. Permit No. r ©a rrs[ f� off, ENGINEER Name License No. Address Telephone Fax PERMIT APPPLICATION SECTION BY D E Zoning , % .� Electrical Mechanical Plumbing Fire Public Works Structural 3 Building Official 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) 0 FIRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES s it ,?t (sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ REVIEWED AND PREPARED BY: PERMIT APPLICATION ISSUING OFFICIAL DATE: Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http://www.miamishoresvillage.com Contractor DONAHUE, JOHN Local Phone: 305 - 945 - 0374 0 Parcel # 1132050130040 Legal Description: PL OF REPPENHAGENS n0 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 -795 -2204 Printed: 4/4/2002 Applicant: PAMELA Owner: MICHELS JOB ADDRESS: 1070 NE 92 ST Fees: FEE2002 -1941 FEE2002 -1942 Permit Status: APPROVED Work: If there is nn fep ' Total Fees: Permit Expiration: Building Permit Permit Number: BP2002-682 Contractor's Address: NE 171 ST - Description Building Permit Application Fee CCF 10/1/2002 MICHELS PAMELA Amount $60.00 $1.80 $61.80 Cone*- tion Value: (Contractor or Builder) verify, there will be no inspections. Re- inspection action. the equipment or device described in the application herefor in strict compliance with all with any plans, drawings, statements or specifications that may have been submitted to not done in compliance with such ordinances or if the plans are changed without tor or builder named above assumes the responsibility for a thorough knowledge of the is or in the statements or specifications and that he assumes responsibility for work done ..umpliance with all ordinances and regulations pertaining thereto and in strict conformity ....dmi Shores Village. In accepting this permit I assume responisibility for all work done by either BY: BY: $1,200.00 Page 1 of 1 PB 41 -100 LOT 5 LOT SIZE IRREGULAR OR 17943 -2639 Total Fees: $61.80 Total Receipts: $0.00 MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: -`,/ OWNER' S NAME%.S°4 .vriveZo /14c/le, 4.5 PHONE: 010 757- ,S 9 ADDRESS: / © ,0 "fig 992 ' ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: ' P p Ate 9:2 el' CONTRACTOR & LICENSE (if applicable) l 2)0,tJA4ue ,'77?-3 670 eci/9 COMPANY NAME: J'e)Av Cam. Dcs4v4AI"e PHONE: 3o.r 95 756 ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on t e site must be listed and indicate the color to be painted. Walls Fascia Drip Cap/Drip Edge o Soffit Roof .A, - ,,I > Flower Bins r-- ro Shutters r tri Awnings Chimney H Doors and door jams I ti z Garage Doors c to tri 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. I authorize the above -named contractor, if applicable, to do t work stated. Furthermore , the paint colors will be as per the attached e ////' /jl /o / Signature of Owner Date ::nature of Contractor Date ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** :* APPROVED: Vilo Building din Office Date 4/23/01 WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Qualifier '<,Joitt c /h PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ,...Y/// l3 Job Address /D 7D W. E, F, d )` Legal Description .1C Owner / Lessee / Tenant 1, =r / ' Gt' /e% Owner's Address //) 70 /V ./ Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: APPROVED: S FEES: PERMITZb RADON C.C.P. APO NOTARY 1 4'80 Tax Folio //J 0 491 i Master Permit 4k../32 Contracting Co. 7) eF // - 7— /61 Address /00 A4 .eX L /04) T ,L4U%/2644E ��. 3330f SS# Phone /- od - 7(7/- V/ 3 9 State # Municipal 0 Competency # 833$' Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION elc'<adJ % r ee S "E i iv T" &cd, I c� , e c/ S e Square Ft. c c1 GoO Cost(value) ® o E stimated WARNING TO OWNER: YOU MU 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 -named contractor to do the work stated. • ( . l yy ,gf/�� tractor or Owner- Builder °V4MRy Pgg ;r er :My Commas El* A/td wmgclutnia aryras to My Commission Phone ** TOTAL DUE ✓ Fire Other Zoning Electrical Mechanical Plumbing Engineering BUILDING ELECTRICAL PLUMBING ROOFING CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. PERMIT N° 5564 Owner of Building Architect Contractor or Builder Legal Lot Description � Bl Address of Building FLORIDA DATE Contractor's License No. 195 Work to be performed under this Permit Subdi- vision Value of Project $ Amount of Permit $ 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. Signed BY: INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work coveted 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 6 STATE OF FLORIDA, COUNTY OF DADE. ss Disapproved MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor Date No / (Signed) Building Inspe or 1f Date , 19 Street - � .. • Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done )0) ° ( ) State work to be done and purpose of building (by floors) and for no other purpose. New Building Remodeling Addition Re No. of Stories To be constructed of Kind of foundation Ro9f Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required Flan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed ).X Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are tru Permit No _ "_ Date s7 Read, Sworn to and Subscribed before me. to me well known, Notary Public, State of Florida My Commission Expires ANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.