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PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date / /3 Job Address 13 / GU e 92 S' Tax Folio Legal Description Historically Designated: Yes No 298 Owner/Lessee / Tenant /!/. C y . .,/,0 SU,i Master Permit # 3d j • Ownsis Address 67 S /-- Phone 7:7 1, fa /7 —SZ o Contacting Co. 74i 4 C6 LO I'_ Address Qualifier SS# Phone Stall: # Municipal # Competency # Ins. Co. Arc'3itect/Engineer Address Bonding Company Address Mc rtgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ,( ` d( 'f (1 , 1Y/ k�'1 t' Spare Ft Estimated Cost (value) ° (0 - 6 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY LESULT 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 Gertify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate .)ermits 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. r Condo President Date as to Owner and/or C do President ate Commission Ex��e 'I!!!liil ! 1F7llN lJ ?l!!!.'X'Illllll!!!!!Nl! o � P pY PV Yvonne Simpson : b ^ Notary Public, State of Florida P " ". Commission No. CC 416266 ��FOFfbu My Commission Expires 12/06/98 FEES: PERMIT 1. 800.3- NOTARY - Fla. No ay ^' ce & Bonding Co. 1111111 111111111 1111111 <;i�:l»1111111111111111111 RADON C.C.F. Signature of Contractor or Owner- Builder Not P NOTARY as to Contractor or Owner- BCtilder ommtssion EX ekle'll!!lliiN %l. iil.'lli i :r!!!l!,!!!!!!!!!.'N!� > �Pay °&s €,. Yvonne Simpson + ' c' Notary Public, State of Florida Commission No. CC 416266 '(voFp.k> My Commission Expires 12/06/98 , 1- 800.3- NOTARY - x11, Notay.:44vice & Bonding Co. »11NYM1)WPAVY ?' WSINVNYsi `AWA))1)))11)11 t TOTAL DUE Da e Date Zoning t C5 APPROVED: � ng Building Electrical Mechanical Plumbing Engineering Date Le gel Description Historically Designated: Yes N9 vy R.essee / Tenant - ', /JQ� A ) &J c Master Permit # '� 5 r Phone 36- C /(&(-) 7Y7 /3 F r PERMIT APPLICATION FOR MIAMI SHORES VILLAGE \ ° t ob Address 13. J q S Tax Folio O1 vnei's Address 1l n Contracting Co. CL C/ Address QI lalifier SS# Phone State # Municipal # Competency # Ins. Co. Aa chitect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): I a I ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION PA-1 i4r o( ( fJ - s ca _da ape ry i 7 I-ir. (Be,, to 1 Square Ft. Estimated Cost (value) 5 W ARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR 1 LYING 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.) AFplication 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 wi [1 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. Notary as to Owner and/or Condo President Date Kr Commission Expires: FEES: PERMIT CV RADON APPROVED: Zoning MI xhanical Building Signature' of owner and/or Condo President Date 6d Signature of Contractor or Owner- Builder Date 3/C a ,L�Q I/ 2 F7 Notary as to Contractor or Owner- Builder ate M Commission Ex tees: NOTARY PUBLIC - STAT OF FLORIDA y p LOIS E. LINDLEY COMMISSION # CC601852 EXPIRES 12.15.2000 BONDED THRU ASA 1- 888- NOTARYI C.C.F. NOTARY — BOND �t_ TOTAL DUE l /) gqif Electrical Plumbing Structural Engineer Fees Due Amount Invoice Number Amt Due Amt Paid CCF Education Surcharge $0.60 $0.20 PT -5 -06 -24758 Total: $67.30 Notary Fee $5.00 /' � 2 � '� J Permit Fee Technology Fee $60.00 $1.50 V �� Total: $67.30 „r 19 E MAY I q 20ofi Issue Date: 5/18/2006 Owner's Name: RAND AND PATRICIA LIEBER Permit Type: Paint Work Classification: Repair .lob Address: 137 92 Street NE 1.omments: IEXTERIOR PAINT Additional Information Miami Shores Village, FL 33138- Type of Work: Exterior Color: YELLOW HAZE Additional Info: Classification: Residential E3uilding Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 11/05/2006 1:ontractor(s) Phone Primary Contractor HOME OWNER Yes 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 :.ubmitted to the proper authorities of Miami Shores Village. In accepting this permit I Assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING F'OOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that ell work will be done in compliance with all applicable laws regulating construction nd zoning. Futhermore, I authorize the above -named contractor to do the work tated. Permit Status: APPROVED Permit Number: PT -5 -06 -1202 Phone: (305)439 -8905 Parcel #: 1132060133170 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 500.00 Required Inspections Final NOTICE: In addition to the requireme®,s'of this permit, there may be additional restrictions applicable to this propertr that-mey—be.f.auriCin the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. v - ectia u Inspection Date: 11/07/2006 Inspector: Grande, Claudio Owner: LIEBER, RAND AND PATRICIA Job Address: 137 92 Street IJE.: P - oject: <NONE> Miami Shores Village, FL Contractor: HOME OWNER Building Department Comments Wonday, November 6, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: -0 Permit Type: Paint Inspection Type: Final Work Classification: Repair Phone Number (305)439 - 8905 Parcel Number 1132060133170 Lot: 6-1202 Page 1 of 2 Passed Inspector Comments Failed Correction Needed Re- Inspection Fee ($ No Additional Inspections can be scheduled re- inspection fee is paid . until v - ectia u Inspection Date: 11/07/2006 Inspector: Grande, Claudio Owner: LIEBER, RAND AND PATRICIA Job Address: 137 92 Street IJE.: P - oject: <NONE> Miami Shores Village, FL Contractor: HOME OWNER Building Department Comments Wonday, November 6, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: -0 Permit Type: Paint Inspection Type: Final Work Classification: Repair Phone Number (305)439 - 8905 Parcel Number 1132060133170 Lot: 6-1202 Page 1 of 2 \)(2) -L-1?_, JS�'�' + r rnsc s 11210C !,33 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle). Owner's Name (Fee Sim. ser) Owner's Address 1 3 J Ai 1 = City ni l'Orn SI-No ce State Tenant/Lessee Name !v/ /'a Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 9°02 STre e . t' F Job Address (where the work is being done) 1 3 - 7 sv & City Miami Shores Villa e Is Building Historically Designated YES NO �C Electrical Plumbing Mechanical Roofing 1 - - ' e 1° PGl i G. «-J AND Phone # 3' c ( 3 9 S x � wN' P Contractor's Company Name Contractor's Address City Qualifier State Zip 3 Phone # l`) / County Miami -Dade Zip 3 3 ( 3 g Phone # State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) $ Value of Work For this Permit t 5 ' Type of Work: ❑Addition Describe Work: e X ief i or Submittal Fee $ jJ Permit Fee $ Notary $ ) c Scanning $ Code Enforcement $ ['Alteration t-tov5 e ( .1 * * * * * * * * * * * * * * * * * * ** Total Fee Now Due $G--7 a (Continued on opposite side) Training/Education Fee $ �• �� Permit No i \ 1l Master Permit No. * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** o � � Radon $ Zoning Bond $ Structural Plan Review. $ RECEIVED MAY 9 2006 Zip Phone # Square Footage Of Work: EJ Repair/Replace ❑ Demolition CCF $ 0. CO /CC Technology Fee $ 1 ' C 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: 1 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 attac ment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which o'curs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will no"1 be a, 'rove and a reinspection fee will be charged. Signature chc 05/13/03 ■ Owner or Agent Contractor The foregoing instrument was acknowledged before me this I i The foregoing instrument was acknowledged before me this day of fl ,20( by �Ifh h/Y?1 - Lf(C(ff• day of ,20by As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC• NOTARY PUBLIC: Sign: J/ Ip r Sign: Print: . . Print: My Commission Expires: My Commission Expires: APPLICATION APPROVED BY: Signature ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * r * * ** ** * ** ** * ** * ** * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * / * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ? ( 7/ Of Plans Examiner Engineer o f: Zoning APPROVED: Building Official Miami Shores Villa 10050 Northeast Second Avenue Miami Shores, Florida 33138 -2382 Telephone: (305) 795 -2207 Fax: (305) 756 -8972 www.miamishoresvillage.com Paint Color Approval and Agreement DATE: 5 / C 6 OWNER'S NA f1 N ,0 Q,vO J e tr r C, U L ADDRESS: /37 (N, ?)- 5/wee ADDRESS OF SITE: / sweee7 CONTRACTOR & LICENSE (if applicable) COMPANY NAME: All Elements on the site must be listed and indicate the color to be painted. Walls: /7Cfn/r -/ . fc.)/L 4 � >ve Fascia: ( � f0/1 Drip Cap /Drip Edge: ,N/ R Soffit: NA Roof: Ter ( Co i'O Flower Bins: N! fy Shutters: /y6 Awnings: 6 A Chimney: #(110 cur\ Doors and door jams! (,Dh ~t e Garage Doors: Railings: U1h Fences: C Decorative Metal: N i9 All brick (simulated regular): n//1 Stucco Banding: [I// ' Any other stucco fe tures: ;n, /fl Accessory /Buildings: (GrA- - mor(vir Smshi..ve Other: Date Date r1) e PHONE:36)g. 5 1O55 PHONE: n 0 r 0 aD o morning sunshine 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 egulating construction and zoning. I authorize the above -named contractor, if applicable, to do the work stated. Furt e ,j�re, the paint colors will be as per the attached samples. Signature of Contractor Date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Miami Shores Village Paint Color Approval. and Agreement Date *She ill y 5 Phone # ?j0,s — ,3 I — cro Owner's Name ► l e _ Owner's Address 3 r l N / al Si'r ee 1 City (nZ1,VA\ State FL_ Zip .4 3 if,g 8 .lob Address (where the work is being done) 1 3 - 7 ev E City Miami Shores Village County Miami -Dade Z '3 1 ? tS Is Building Historically Designated YES NO X. Contractor's Company Name (if applicable) IN `� Phone # All elements on the site must be listed and indicate the color to be painted Walls Ilou) Haz Fascia Drip Cap /drip Edge t3 Soffit Roof Terra cv 1 Flow bi ns Shutters Awnings A Chiinney ye 11 o w Paz E Doors and door, lams (AI I t e Garage doors 1 j t Railings LeIVN tt Decorative metal Fences Signature APPLICATION APPROVED BY: A y/1 All brick (simulated or regular) Stucco banding OVh Any other stucco features iN / A Accessory Buildings b4ra qP - y e n O o 'ka E Other (J ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** OWNER'S AFFIDAVIT: I certif that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulatiu cot to /on and zoning. Owner or Agent O - L tOZ Date Date O �t 3 // chc 6 /18 /03