321 NE 93 St (10)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Li - 3- 9 S° Job Address a 1 N E Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant MOO/ 7 O en n n O (-
Owner's Address a l NE Q 3 S+-
Contracting Co. () w r r
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company
Mortgagor
Permit Type (circle one) BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
(LMMTE 7v Wk(rr
WORK DESCRIPTION 'R n o+ LS ac 4-e rt a r
Address
Address
Address
Master Permit #
Phone 7 5 I - - 7 2 _ 0 0
Square Ft. Estimated Cost (value) ( 500,
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 olvne
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT ?it, , RADON
APPROVED:
Zoning
Mechanical
0 (,. a-v Al /a /iG
d/or Condo President Date
Building
Plumbing
or O Builder Date
Notary as to Contractor or Owner- Builder
My Comn issioi xpjres:
Electrical
JI
Date
V 3 - 9c
C.C.F. ► NOTARY 5 - TOTAL DUE 4,S'_
Engineering
Inspection Number: INSP -6766
Inspection Date: 02/07/2006
Inspector: Grande, Claudio
Owner: SHOCKEY, DONALD
Job Address: 321 93 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Monday, February 6, 2006
/ L
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Ph e: (305)795 -2204 Fax: (305)756 -8972
Block: •
Permit Number: PT -1 -06 -166
Permit Type: Paint
Inspection Type: Final
Work Classification: Miscellaneous
Phone Number 305 - 772 -8160
Parcel Number 1132060136240
Lot:
Page 1 of 2
Passed
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP -6766
Inspection Date: 02/07/2006
Inspector: Grande, Claudio
Owner: SHOCKEY, DONALD
Job Address: 321 93 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Monday, February 6, 2006
/ L
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Ph e: (305)795 -2204 Fax: (305)756 -8972
Block: •
Permit Number: PT -1 -06 -166
Permit Type: Paint
Inspection Type: Final
Work Classification: Miscellaneous
Phone Number 305 - 772 -8160
Parcel Number 1132060136240
Lot:
Page 1 of 2
BUILDING
PERMIT APPLICATION
FBC 2001
Tenant/Lessee Name
o
$ Value of Work For this Permit / 00 9
Type of Work:
Describe Work:
Total Fee Now Due $
(Continued on opposite side)
68. 10
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305 795.2204 Fax: (305) 756.8972
Permit Type (circle): Building Electric . Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) ( PC� , Q C 6( 54-p &y Phone # (3 S) 77e $I e0
Phone #
Contractor's Company Name Phone #
Contractor's Address
Permit No. PrOrc — 1 L
ter Permit No.
Job Address (where the work is being done) 3 Z / /1/. E. 93 t d - 57-
City Miami Shores Village County Miami -Dade Zip 33 / 3 b
Is Building Historically Designated YES NO X
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
['Addition ['Alteration ❑New
C X
-1-€,;( / �� t� -/,
Square Footage Of Work:
❑ Repair/Replace ❑ Demolition
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ l 0 CCF $ 1- 2-0 CO /CC
Notary $Z5- 00 Training/Education Fee $ 0 . 4 1-C7 Technology Fee $ r .5cJ
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 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 approv • - . d a reinspection fee will be charged.
Signature
Owner sr i gent Contractor
The foregoing instrument was owledged before me this 2.0 The foregoing instrument was acknowledged before me this
day ofJ A N- , 2 0 ° Q b c � ( � 1 Q L 4 , day of , 20 b
Y
who is personally known to me or who has produced who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY
Sign:
Print:
My Commis
161 '
APPLICATION APPROVED BY:
chc 05/13/03
As identif ation and who did take an oath.
Y PIJBIIC.S�' 0 •RIDA
W/%�.�eZ
A1 ;-A=A, 4 ,..
= '1.Thrimu
Co., Inc.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * ** * ** * * * * * * * * ** ******************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * ** #ss * ** ******** * #,, * * ss * *s * * * * * * * * * * * * * * * * * * **
Signature
Plans Examiner
Engineer
Zoning
Miami Shores Village
Paint Color Approval and Agreement
Date 00*
_ 1 //�
Name 6 Ina Vkocke Phone # 365 7 72 Fl 60 Owner's Nam � y Owner's Address , 3 a I � '• � I �/
t 6VtS UA V (e-/ State FL- Zip S31 1(
Ci , A��
Job Address (where the work is being done) 6a I 1\) '3,Y,A s'f "
City
Miami Shores Village County Miami-Dade Zip 3 3 (J _/
Is Building Historically Designated YES NO n
Contractor's Company Name (if applicable)
----� Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painte
Walls
5 eel 6/ 6 9 5e 6t4 e e KA
Fascia W H ii-e. /
Drip Cap /drip Edge /.1 tahi l A1/ M 691.9A
M
Soffit W ' ,� ' e
Roof
Flower bins
Signature
Shutters --
Awnings
Chimney
Doors and door jams
Garage doors LU I-1(
e' y
Railings
S w 616 9 SQd 4 /( �'-f ?
Fences
Decorative metal
All brick (simulated or regular) ✓°
w 6/6q sea -k iMI
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 laws regulating construction and zoning.
er or Agent
• APPLICATION APPROVED BY:
P&. Z Official
SW 6169
Sedate Gray
white
Date
Date
b6166
0/(1 G
chc 6/18/03
Issue Date: 1/20/2006
Owner's Name: DONALD SHOCKEY
Permit Type: Paint
Work Classification: Miscellaneous
Job Address: 321 93 Street NE
Contractor(s) Phone Primary Contractor
HOME OWNER
Yes
Comments:
EXTERIOR PAINTING
Additional Information
Miami Shores Village, FL
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 01/20/2007
Type of Work: Exterior Color: SEDATE GRAY, WHITE AND ALUMINUM
Additional Info:
Classification: Residential
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 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
POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Building Department File Copy
Applicant Signature
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: PT -1 -06 -166
Phone: 305 - 772 -8160
1132060136240
Lot:
PB:
Total Square Feet: 0
Total Valuation: $ 1,200.00
Required Inspections
Final
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology Fee
Total:
Amount
$1.20
$0.40
$5.00
$60.00
$1.50
$68.10
Invoice Number
PT - 1 - 06 - 23546
Total:
rJAN 2 0 PAID
Amt Due
$68.10
Amt Paid
$68.10
$68.10
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in 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.