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BP2003-1049Date Type Insp'n Permit No. MIAMI SHARES •VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Name P,-c Address Company Phone # Inspection Date, / / (((( � D Approved Correction Re- Insp'n Fee ❑ BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): city morn s MAP s Tenant/Lessee Name Owner's Name (Fee Simple Titleholder) Owner's Address k 0 9 0 State Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name --4 City Qualifier $ Value of Work For this Permit Code Enforcement $ Bond $ Electrical Plumbing Minus Plans Check Fee $ Fee Totals $ Miami Shores Village Building Department ennc Beer. CPS- 3- F t Zip 3 3 p \,bbd County Miami -Dade NO Permit No. B li . J 11A Master Permit No. Mechanical Roofing Phone # Phone # Phone # 5� —) S p 57 Contractor's Address �� ,g4• A S e Zip zcz Architect/Engineer's 's Name (if applicable) Architect/Engineer's Address City State Zip County Escrow Fee $ ( a 0 Permit Fee $ 4 O --, Education/Training Fee $ Tech $ Scanning $ Struct. $ ,C .CC) Phone # Square Footage Of Work: Number of: Bays Stories Families Bedrooms Type of Work: ['Addition ['Alteration ❑New ❑ Repair/Replace Describe Work: ink \off e.sg ti Blot k- knCoSe RECE VED JUN 6 2003 * * * * * * * * * * * * * * * * * * * * * * * * * ** *Fee Calculation -Misc Permits * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Zip Baths ❑ Demolition Notary $ Radon $ (Continued on opposite 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. . -, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection 'ch occurs 'en (7) da s after the building permit is issued. In the absence of such posted notice, the inspection will not be a roved - a reinspe yr• ee will be charged. Owner • Agent The foregoing instrument was acknowledged before me thi ,200) ,by who is personally known to me or who has produced NOTARY PUBLIC: Sign: Print: My Commission Expires: 123 As identification and who did take an oath. *************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency, No. APPLICATION APPROVED BY: chc6 /I 8/03 Y PUBLIC: Sign: Print: My Commission Expires: e 5 Contractor The foregoing instrument was acknowledged before me this ,'- day of ifiwxlt.- , 20 , by who is personally known to me or who has produced as identification and who did take an oath. JUL _ 3 2003 Plans Examiner Zoning DATE• O 'S NAME: )( PHONE: ADDRESS: �I * * * * * * * ** ************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and Walls csvin i Fascia -61 e9 Drip Cap/Drip Edge ffA Soffit Roof MIAMI SHORES VILLAGE Paint Color Approval and Agreement Flower Bins ,c Shutters zu..r t S Awnings �C Chimney �. Doors and door jams Garage Doors Railings Fences Fences Decorative Metal All brick brick (simulated or regular) K Stucco Banding Any other stucco features 2 Accessory Buildings Other APPROVED: a( ', x/03 Building Official — Date indicate the color to be painted. ,0 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 samples. ignature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 Date Legal Description Lc;�y ^� q‘.1 "4: Historically Designated: Yes No 'X' Owner/Lessee / Tenant % V a'ck,6 Q t Owner's Address 10 I4 F ,�� Contracting CgCf11'1�(�I� �� �� � � /��/V Address ,�,�d i..W0 ,/ /W // Qualifier w J�� .N 'i /� . SS# Phone )?/ , 4 i 2 J � Competency # 0/7 y© S Ins. Co. 'w 6r14 576/2., Architect/Engineer Address Bonding Company Address Mortgagor Address state # /a/ 7D 2 - Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION A0 /An Square Ft. Estimated Cost (value) 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 -named cgntractot to do the work stated. Signature . owner and/or Condo President 4 44 401111mare.,..., tary as to Owner and/or Condo President Date My Commission Expires: it ••,attei% JAMES F. GOLDBLATT : +: �•� :.: MY COMMISSION # CC317437 EXPIRES '•._kr'p' October 22, 1997 RT FyQ BONDED THRU TROY FAIN INSURANCE, INC. FEES: PERMIT '/6 . © 0 RADON PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address /O9O44 12nota7 Tax Folio - O M # H. 9 Date 1 a ( 'n V APPROVED: Zoning Building -- / ��i� Electrical Mechanical Plumbing Notary as My Co C.C.F. /, O 0 NOTARY Master Permit # Phone S 1- V 1 ,) -- o0`1 ontractor or Owner- ssion Expires: Signature of 6ontract6 or Owner- Builder � a •; Date TOTAL DUE 'gill O 0 Engineering