PAINT0 n�
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FEE2005 -12170 Training and Education Fee
FEE2005 -12171 Technology Fee
Total Fees:
Signed: (INSPECTOR)
0
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•1
$0.60
$1.50
$63.90
CD
CTQ
0
Permit Status: APPROVED Permit Expiration: 2/28/2006 Construction Value: $3,000.00
Work: PAINT HOUSE
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BLK 3 LOT SIZE 75.000 X 125 OR
Total Fees: $63.90
Total Receipts: $0.00
SEP12Pf-
I
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 1 assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
I"
BUILDING
PERMIT APPLICATION
FBC 2001
Job Address (where the work is being done) I kL
Contractor's Company Name ✓Y'Z 1'
Total Fee Now Due $
(Continued on opposite side)
63, ac
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (3Q5) 79544 fax: (30 ) 75.6.8972
1' t
Permit Type (circle): Building Electrical Plumbing, ! M Roofing
Owner's Name (Fee Simple Titleholder) .� ;�( i �� ° ° ✓l on I ( " --4 - ) — 1 ( ) —I –' I J :I (L) •
Owner's Address . iN ! k, N 1' (-- 1- - ) 1 S i
City�1 � i A 1 � l \ J ,1-‘ State �,, Zip / ) \ 4
Tenant/Lessee Name Phone #
Is Building Historically Designated YES NO 7
(-
Permit No. E')Pr-S ' 11
Master Permit No.
City Miami Shores Village County Miami-Dade Zip "
Phone #
Contractor's Address
City_ State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
k" $ Value of Work For this Permit
Type of Work: ['Addition ❑Alteration ['New ❑ Repair/Replace ❑ Demolition
Describe Work:
Structural Plan Review. $
Square Footage Of Work:
* * * * * * * * * * * * * * * * * * * * * * * * * * ** Fe * * *w * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ L/ 0 CCF $ { • 80 CO /CC
Notary $ - - Training/Education Fee $ 0. (00 Technology Fee $ t s
Scanning $ Radon $ Zoning Bond $
Code Enforcement $
c4
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
'. 1
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.
Signatur
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of5Q1.14 , 2005 , by , day of , 20 , by
who is personally known to me or who has produced 1 Or i who is personally known to me or who has produced
d ruid( I i('Scc- As identification and who did take an oath. as identification and who did take an oath.
My Commission Expires:
* * * * * * * * * * **
* * * * * * * * * **
\PPLICATION APPROVED BY:
1 13/03
* * * *EItlHMM ANAPATA ER
,x.11,
' MY COMMISSION # 00 t �>
EXPIRES*. ta ry P W I,u ero
Bonded Thru
Signature
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ** * * * *w ** * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
Miami Shores Village
Paint Color Approval
Date OD _
Owner's Name rQ + t,j (70
D t
Owner's Address n V 1 q I S
City 1 1` �)� State
Job Address (where the work is being done) l \l
City Miami Shores Village
Is Building Historically Designated
YES NO
Contractor's Company Name (if applicable) Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
II rr ��
All ele ents I ona the site must be listed and indicate the color to be painted
Walls Ci D V V/ N r Ii
Fascia
Drip Cap /drip Edge
Soffit
Roof
Flower bins
Shutters
Awnings
Chimney
Doors and door jams
Garage doors
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 1 ws regulating construction and zoning.
Signature
APPLICATION APPROVED BY:
Owner or Agent
County Miami -Dade
and Agreement
Phone # 3 ()5 151 1 b( CO
Zip
3. 15 V
Q i I k
Date /476—.1
chc 6/18/03
Date
4,
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 2 - `/'l Job Address 12 7 Ci �` �' Tax Folio
Legal Description Historicdly Designated: Yes No
�- Ia
Owner/Lessee / Tenant CJ ` _ f S � e Master Permit # 1 (0 / e./c7
Owner's Address (')T) c3 i-' 9-1_ °;-/--- Phone
Contracting Co. 0\44 /t! E P2._ Address
Qualifier SS# Phone .
State # Municipal # Competency # Ins. Co.
Add.
Architect/Engineer
Bonding Company
Mortgagor Address
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
Address
- 2 5 - /s7
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION - \ - LS7j `ite ® �
6
Square Ft. Estimated Cost (value) g e 6-0
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 cs 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.
3 ?VNER'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.
7
Notary as to Contractor or Owner - Builder
My Commission Expires:
S gnature of C tractor or •wner- Builder / Date
?5 7 ,j
Date
FEES: PERMIT 4 Cr RADON C.C.F. • (.`-: NOTARY BOND
TOTAL DUE ( 4 c
APPROVED:
Zonin g g Buildin < Electrical
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date/9 /.0 Job Address /,'4W 1 / (5 Tax Folio cVaisc. 41574°/
legal Description/1 ,5 414n-el
Owner / Lessee / Tenaht % JO = Q- l t (A/ L rI S(± v- r Master Permit al
Owner's Address / ._.,1,,, N,'_ 79 9 - Phone 75 :J=7 '
Contracting Co. eaza Address
Qualifier SS# - - Phone
State # Municipal iP Competency 4 Ins.Co.
Architect /Engineer Address_
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION f29A, ("
Square Ft. Estimated Cost(value) 5 C'C'• c 'e )
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 :reformation 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 S,atr Owner- Builder
Date : A(( e
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * * * * * * x
FEES: PERMITJ 2..5 0 RADON C.C.F. 6 V NOTARY 5P12 TOTAL DUE g3/0
as to C
My Commission
Mechanical Plumbing Engineering
**
Other
APPROVED: Fire
101t7' 1
Zoning :uildin `!" (12 Electrical