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PAINT PERMITSMIAMI SHORES VILLAG BUILDING DEPARTM NT 305- 795 -2204 Building Inspection Request Date Type Insp'n Permit No. 7)pDDOo`-1 — y Name OT I [[[ V Address 530 E G 5+ Company 6W IV l/ Phone # Inspection Date 5/I Approved i71 4 Correction ❑ Re- Insp'n Fee ❑ tP BUILDING PERMIT APPLICATION FBC 2001 Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit) " SM °' Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 0 - - 2- . ?lam 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Square Footage Of Work: * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit No. 15P 7C1 Master Permit No. Permit Type (circle) Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simp der) C ilt.�� \. ► Phone # , --, 1 sk Owner's Address � }� lC G %- �..1�= e' -� . ) .�� �`�r \ C7 � ` �. C._ S 3 r) /\J' i - l City � cam: �. ; SV•� =) State 1� Zip �� 0.) ��- Tenant/Lessee Name Phone # Job Address (where the work is being done) 3 C/ c- C j I . J City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name " C Phone # Contractor's Address City State Zip Qualifier Type of Work: ['Addition ❑Alteration ❑New � ID Repair/Replace ` 11 De lition Describe Work: ` �� i'Y` �--� e vr��' 1� \ 1 1 .) v f 1 y . Submittal Fee $ Permit Fee $ 0, CL CCF $ : ,C . CO/CC Notary $ 4 . 00 Training/Education Fee $ . Po Technology Fee $ i , 50 Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ 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 promise in good faith that a copy whose property is subject for the first inspection inspection will not be Signature Chc 12/15/03 ent.'A seven a reins atta h occ ved and The fore oin ' trument was acknowledged before me this 9 • The foregoing instrument was acknowledged before me this day.of �4 ( 20G4, by aQ`([OY 'ClPV e3 1 CGS (' . day of , 20 _, by who is per onally known to me or who has produced As identification and who did take an oath. APPLICATION APPROVED BY: to the issuance of a building permit with an estimated value exceeding $2500, the applicant must otice of commencement and construction lien law brochure will be delivered to the person o, a certified copy of the recorded notice of commencement must be posted at the job site (7) days after the building permit is issued. In the absence of such posted notice, the ection fee will be charged. Signature Contractor who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: CV Y Mabel Vtugar Sign: s �` Print: o fig, Commission #DD231984 Print: • " : *_ xpires: Jul 13, 2007 My Commission Expires: -9,.. • .,� Bonded Thru My Commission Expires: ************* * * * * * * * * * * * * * * * * *45W * * * *414T4i PI Inc •** n * " ************************ * * * * * * * * ** * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. 6e•-v y1) APR 212004 ************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** , **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** . Plans Examiner Engineer Zoning • Date Owner's Name Owner's Address City State Zip Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip Ls Building Historically Designated YES NO Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All ele ents on the site must be listed and indicate the color to be painted Walls 0\ Fascia Drip Cap /drip Edge fbnci (Cu d Soffit Roof I 0 Flower bins 0 Shutters &O( SI_1`r) Awnings N-K Chimney NU Doors and door jams FfOc Garage doors Railings Fences Decorative metal All brick (simulated or regular) Stucco banding Any other stucco features Accessory Buildings Other /)) y OWNER'S AFFIDA applicable laws regula Signature APPLICATION APPROVED BY: Miami Shores Village Paint Color Approval and Agreement that all the oregoing information is accurate and that all work will be done in compliance with all ction and zo g. Owner or Agent P& Z Official Phone # 1 Q3 A I ;amples " JISPS bers p Date Date chc 6/1$/03 Date 0 Walls Owner's Name Owner's Address City `A vo,Aqj Miami Shores Village • Paint Color Approval a__ -- Agreement �,� o,�,, � ®� O © �( 1 / 6 c( Phone # 0N1� 'EC . ".1 S I 'M State Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Fascia JCIVI ok 06A C w 5 Drip Cap /drip Edge 19 l v 3 LA.7 6 k `\— Soffit 9 lvVv` _ S `'J 6 lOT Roof -�-� Flower bins Shutters Awnings Chimney nn__ � Doors and door jams � 0:2�`'^* Garage doors u / 1^ Railings Fences Decorative metal All brick (simulated or regular) Stucco banding Any other stucco features Accessory Buildings Other \ \ N S ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** OWNER'S AFFIDAVIT: I ce ' •t al - • : information is accurate and that all work will be done in compliance with all applicable laws regulating co ' • n and zoning. Signature APPLICATION APPROVED BY: finer or Agent Zip 3 1 Q County Miami -Dade NO a wAf.eAA Zip ate II /o ° ' \S e les chc 6/18/03 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2004 -490 Printed: 4/21/2004 Applicant: ORIELT TSVI Owner: TSVI MARGELIT JOB ADDRESS: 530 NE 91 ST Contractor Local Phone: Parcel # 1132060400010 Signed: (INSPECTOR) Building Permit Contractor's Address: Legal Description: PARK MANOR HOMES PB 86 -52 LOT 1 BLK 1 LOT SIZE 7150 Permit Status: APPROVED Permit Expiration: 10/6/2004 Construction Value: $800.00 Work: PAINT EXTERIOR OF HOUSE AS AGREED Page 1 of 1 Fees: Description Amount FEE2004 -4068 Building Painting Fee $60.00 FEE2004 -4069 CCF $0.60 FEE2004 -4070 Notary Fee $5.00 FEE2004 -4071 Training and Education Fee $0.20 FEE2004 -4072 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: Signature of o ,, s 4 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 53 ke q/ / 5/41 Tax Folio Date Legal Description Historically Designated: Yes No 2< Owner/Lessee / Tenant 01 C!` `- ' (/ -_so / M asterrPermit # 4 7 '32 Owner's Address S /I e 5/ S �� WORK DESCRIPTION C ` r" ` •� `I§ x' P ?f T > aAt° j2 j 1/4 N d/or Condo Pres n Exp' MAAYNOR C. MILIAN Notary Public - smote of Ftcdc, dd My CornmWRAn bytes Sep 7. O107 Commission # CC 869466 FEES: PERMI*0 RADON Contracting Co. 0 ( Alti(F Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer ,- Address '7C Bonding Company ,-<' Address Mortgagor 7<- Address t 1 )ce Phone Y' 7 l( y - (T rcrio Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Square Ft. OWo 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 al the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furtherm , I authorize the above -named contractor to do the work stated. l �<j /�l(�J ate Signature of Contractor or Owner- Builder Date Notary as to Contractor or Owner- Builder Date My Commission Expires: C.C.F. j 0 NOTARY BOND ad a APPROVED: TOTAL DUE 6 j // - Zoning Building — ( q VJ t Electrical Mechanical Plumbing Structural Engineer MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: 7°7 OWNER'S NAME: alfi I a' L2' 73P% PHONE: 9 z•5 ` 3 ADDRESS: $Y / e i/ Ste/ ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE ' applicable) /I COMPANY NAME: /j/ PHONE: ///1 * * * * * * * * * * * * * * * * * * * * * * * * ** * **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls Fascia Soffit Roof Flower Bins Shutters Awnings Chimney Doors and door jams Wem OfeivA. Garage Doors h Rauvn Railings Fences Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features Accessory Buildings Other AV, f flil'it '/ _ 4( 011 AIM 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. Furthe ore , the paint colors will be as per the attached ("/ Ol/1/4 Signature of Owner Date Signature of Contractor Date ***************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: samples. Building Official Date • �h ., 3or)