BP2004-1488Date
Type Insp'n
Permit No.
Correction
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buil. ng Inspection Request
Name C)' O Cn
Address rr�� 1P- t
V
Compan ( r
Phone # 1
Inspection Date
Re- Insp'n Fee ❑
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/19/2004
Applicant: JOHN
Owner: ORGREN
JOB ADDRESS: 121
Contractor
Local Phone:
Parcel # 1132060133160
NE 92
Signed: (INSPECTOR)
Signed: (Contractor or Builder)
Building Permit
Permit Number: BP2004 -1488
ORGREN
JOHN
ST
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 5/11/2005 Construction Value: $600.00
Work: PAINT HOUSE EXTERIOR
BY:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 E1/2 OF LOT 16 & LOT 17 BLK 23 LOT SIZE
Fees:
FEE2004 -1 1 1 92
FEE2004 -11193
FEE2004 -11194
FEE2004 -1 1 1 95
FEE2004 -1 1 1 96
Description
Building Painting Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Total Fees:
Amount
$60.00
$0.60
$5.00
$0.20
$1.50
$67.30
Total Fees: $67.30
Total Receipts: $67.30
4/0k 4
P41
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.
Permit Type (circl
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
Owner's Name (Fee Simple Titleholder) J °� 0 "� e` Phone # 3 0 5 1 5 I- 1 3 0 b
Owner's Address I Z I ✓) C. ci 2 5 i L. c L►
City M 5 h cr -C S State F Zip 3 3 13 g
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
Miami Shores Village
Building Department
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO ✓�
Contractor's Company Name
Contractor's Address
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
Type of Work: ['Addition
Describe Work:
(Continued on opposite side)
0
n ( Q
5 -ei if
.
Alteratio New
v
Code Enforcement $ Structural Plan Review. 5
Total Fee Now Due $
la 7 '' 003
Permit No. BP 9 00 - - 1 vsp
er Permit No.
Phone #
Phone #
Square Footage Of Work:
Mechanical Roofing
Zip
❑ kepair/Replace
❑ Demolition
ALOE "I, a i
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee Permit Fee $ �� CCF $ 0 6° CO /CC
Notary $ Training/Education Fee $ 0 Technology Fee $ l t-
Scanning $ Radon 5 — Zoning Bond 5
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 attachmgnt.v.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
NOTARYi IQ.
Sign:
Print:
My Commission E
APPLICATION APPROVED BY:
Chc 05/13/03
Signature
Owner or`/Agent l Contractor
The foregoing instrument was acknowledged before me this �� The foregoing instrument was acknowledged before me this
day of -✓llgt.0` , 20 Q(, by ?IA-14dt , day of , 20 , by
who is personally known to me or who has produced `L b L who is personally known to me or who has produced
identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
gyv. ,.1s:ssluituandcox3/,:r1:4404,' •
. oUl ,.03 guipuog oguepy
' L p0.uog Sii aq. a.
USE
************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * *42 ********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
NOV 1 6 2004 Plans Examiner
Engineer
Zoning
Date
Owner's Name
Owner's Address
City
Walls
Fascia
•
1 0
Drip Cap /drip Edge
C c >— G
( Z\ _
Soffit
Roof
Signature
APPLICATION APPROVED BY:
Miami Shores Village
Paint Color Approval and Agreement
0 C ve
✓∎ L G12- s - -
5 4—`4- J State r Zip 3 1 37
Job Address (where the work is being done) S
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
C
G
Flower bins
Shutters
Awnings
Chimney
Doors and door jams
C .7 L
Garage doors c '7
Railings
7( .—. c
Fences C
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 al
applicable laws regulating construction and zoning.
Owner or Agent (//gh
P& Z c ial
Phone # `3 U S 5 1 13 o0
Zip
Contractor's Company Name (if applicable)
Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
N c")
,
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/19/2004
Applicant: JOHN
Owner: ORGREN
JOB ADDRESS: 121
Contractor
Local Phone:
Parcel # 1132060133160
NE 92
Fees:
FEE2004 -11192
FEE2004 -11193
FEE2004 -11194
FEE2004 -11195
FEE2004 -11196
Description
Building Painting Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Total Fees:
Amount
$60.00
$0.60
$5.00
$0.20
$1.50
$67.30
Total Fees: $67.30
Total Receipts: $67.30
ivo
Permit Status: APPROVED Permit Expiration: 5/11/2005 Construction Value: $600.00
Work: PAINT HOUSE EXTERIOR
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)
Building Permit
Permit Number: BP2004 -1488
ORGREN
JOHN
ST
Contractor's Address:
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 E1/2 OF LOT 16 & LOT 17 BLK 23 LOT SIZE
BY:
Page 1 of 1
�4p4 /
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/19/2004
Applicant: JOHN
Owner: ORGREN
JOB ADDRESS: 121
Contractor
Local Phone:
Parcel # 1132060133160
NE 92
Building Permit
Permit Number: BP2004 -1488
ORGREN
JOHN
ST
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 5/11/2005 Construction Value:
Work: PAINT HOUSE EXTERIOR
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 E1/2 OF LOT 16 & LOT 17 BLK 23 LOT SIZE
Fees:
FEE2004 -11192
FEE2004 -11193
FEE2004 -1 1 1 94
FEE2004 -11195
FEE2004 -11196
Description
Building Painting Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Total Fees:
Amount
$60.00
$0.60
$5.00
$0.20
$1.50
$67.30
Total Fees: $67.30
Total Receipts: $67.30
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.
(Contractor or Builder)
BY:
$600.00
Page 1 of 1
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
c ro
Date 2 t A.lal 99 Job Address 1 ZI !' F 3 Z S 7- Tax Folio
Legal Description Historically Designated: Yes No
Owne - / Tenant k J" r N N D.P-•o
Owner's Address /a) N �r n 7.2 sy-
Contracting Co. - 8'( ow ' Address
Qualifier SS#
State # Municipal # 1
Architect/Engineer
TALCS
Bonding Company A 2/B 360110 1 1 5
Mortgagor ru G33
Permit Type (circle one): UILDIN Q ELECTRICAL PLUMBING MECHANICAL ROOFING
WORK DESCRIPTION ( X
Signature of owner and/or Condo President Date
P . n(G £nrek(og. n1 41'ow S
Square Ft. Estimated Cost (value) 5( ?CO
Notary as to Owner and/or Condo President Date Notary as
My Commission Expires: My Comm
Master Permit #
Phon ? j'o C J - 79 -6TCa
Phone
PAVING FENCE SIGN
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 contractor to do the work stated.
tore of on
b o Z
Ti-=h,.. 10 1 ,1 , .41
Date 7
ion Expir ADYS 1 VILLAR
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC 714103
MY COMMISSION EXP. MAR. 1,2002
l /
FEES: PERMIT > V RADON
APPROVED:
Zoning Building 1117/ Electrical
Mechanical Plumbing Structural Engineer
C.C.F. 6 &. NOTARY BOND
TOTAL DUE 55'�
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ,,?/- hre - 9S' Job Address 42 / Ne 9 2 S / Tax Folio
M /g Mr 5fifoRc5 AL_ 3 3/ 3 g
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant /itjsi /f, ANA/AN)
Owner's Address 12,/ mg 92 St ' 4f /A'/t// , sm s GL 3.7/ 3$
TR/M
a
• TIM) SHUJA MUMTAZ
FEES: PERMIT I2 RADON C.C.F. NOTARY
Master Permit # 3d ;7
Phone 637 — C5t 4
Contracting Co. 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 OA/NT E.rTF2 /o /Z di T,�rr /1005 w /T/.< l.Jm
Square Ft. Estimated Cost (value) 6t)
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 contractor to do the work stated.
Signature of owner and/or Condo President Date Signature of Contractor or Owner- Builder Date
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
TOTAL DUE
APPROVED:
Zoning Building ' 1 Electrical
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 9r Job Address /2/ NC 9,4 S f aft o / s Po(ax Folio
c- 33/38
Legal Description s4ST 1-OT /6 g tor /7 RL4c1C 2 3 ac .N /AMA SI/e.E'ES SEcTia , J ate
Owner / Lessee / Tenant Master Permit it 56 SW
Owner's Address /2/ Nt 92 ,S71 ',% 'ES j 39/5K Phone /41- 310- 4 97.f? -e E 6s/ YZo6
Contracting Co.(SE[L ) I(14k /L 4HMR -n Address 40/2/ AJE 92 SI Aimii/
ow nJ6 , L 33/ 3g
Qualifier SS ## Phonr', - y 998 ^ eve 6S/ -$2
State # Municipal # Competency # Ins.Co.
Architect /Engineer
Bonding Company
Mortgagor
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION PA-/nE Ei)77'R Alit.t/NAJK AkInG 7b /73 O P /K/A).4z Ca
Ex TEA' 02 o f 7HE /oC /4)/Lt BE DAi J TED zumirE •
M /4 fx67 i-crA✓G 074)OP/ ove T1rg u//noPoi . . DOoAS
25 ( 1l Gioss L/v /N6;
Square Ft. 9600 S6l•F', 4gez, 10 co, Estimated Cost(value) y 3 6.3
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 contractor to do the work stated.
xrith-Q A64,_
Signature of owner and /or Condo President
Date: NOTARY PUBLIC; STATE . AT LARZ
NOT ARYPtatiMMIISSION X' `- .'..%av::�' 1 1
MY COM 'fi ROMUC.KJ ag 6 fATes
Notary as o ci a1' do
My Commissiot -_ :. „1a- yAritelf.,r_ _
** * * * *
APPROVED:
•
dent
*
Zoning
Address
Address
Address
Signature of Contractor or Owner- Builder
Date: /S 5EP
Notary as to Contractor or Owner- Builder
My Commission Expires:
* * * * * * * * **
RADON C.C.F. NOTARY TOTAL DUE
Fire / Other
Buildin: �` Electrical
Mechanical Plumbing Engineering
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 / i '
Registered Architect and/or Engineer
Name and address of licensed contractor G 15(7h6 t • / Y F/v-oU (O - 2 $- • C'c.Q;e Y ^L • - ?
Location aryl legal description of lot to be built on: !�f n�� /� M / .1.;-0 4 ( g
Lot E / i� 1 1 Block eT 3 Subdivision " / s i /P 1l .1.;-0 / 3 g id e t!
/Z /a(6., 9 Z J'reL
Street and Number where work is to be done
State work to be done and purpose of building (by floors), state exterior colors (submit samples) ®/z�sr cr4? ..44" C m
p49yor /7e 0%. T,z 76 .
and for no other purpose.
New Building Remodeling Addition Repairs No of Stories /
To be constructed of AA Kind of foundation Roof Covering
Estimated Total cost of improvements S / / Amount of Permit S f �
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all 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 permit does hereby certify that he understands and accepts his obligatons 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 such subcontractors, on work to be performed
under this permit. as are licensed by Miami Shores Village.
Remarks (Sign
STATE OF FLORIDA
COUNTY OF DADE.
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 true.
Permit No. .f- 1 96 2 0 )
(Signed)
}SS.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Before me. the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments, personally appeared
Date 6
Disapproved .\ a\ 1 / Date
Date S ` r ^
No. 1 2 1 N C Street
19
92
Read, Sworn to and Subscribed before me.
Notary Public. State of Florida
to me well known.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
'Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and%or workmanship.