PAINTBUILDING
PERMIT APPLICATION
FBC 2001
iami Shores Village
Building Department
0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): Building Electrical Plumbing Mechanical rr Roofing
Owner's Name (Fee Simple Titleholder) N I CQ I € Stu 9C P1 Phone # ' g �, 30 b 91i ci
22
Owner's Address . 5 IN a. ci �4 n (l, Sr I
City 1 PAI %.n` gb State Zip 3 - " t t , ) ?
Tenant/Lessee Name / Phone #
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
$ Value of Work For this Permit 6 h O, 0 b
Type of Work: ❑A dition ElAlteration
Describe Work:
County Miami -Dade
NO
Permit No.
Master Permit No.
a),
Zip
Contractor's Company Name N
( )4 Phone #
Contractor's Address I
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
❑New
Square Footage Of Work:
❑ Repair/Replace ❑ Demolition
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
o3 L
Submittal Fee $ Permit Fee $ �, CCF $ v 0 CO /CC
Notary $ S, P v Training/Education Fee $ b Technology Fee $ ` , S 0
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ j ( 11 3 V' p i Ii\-/ ` C
(Continued on opposite side)
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 pennit 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 82500, 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 pproved and a reinspection fee will be charged.
Signatures / (jQ t ?Q / ,fi , Signature
Owner or Agent Contractor
The fo oing instrument was cknowledged befo e me this The foregoing instrument was acknowledged before me this
day , 20d "' y 4 r1 [ , , day of , 20 _, by
is personall known to me or who has produced 1.1) 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.
NOT
Sign:
Prin
IC:
My Commission Expires:
APPLICATION APPROVED BY:
Chc 05/13/03
bioL TWStu�;^
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
NA 2 4
g 2 - 3 4)7
Plans Examiner
Engineer
Zoning
Miami Shores Village
Paint Color Approval and Agreement
Date 0 0 0 /- q
lH lc,oke-- SUIS�- Phone# 1% 3o 1 ∎ 2
Owner's Name
Owner's Address 35 L n d
CityT P\ h n r-PS State Zip 3 \
Job Address (where the work is being done) 3 J N - e _1 nc-A S re P
City Miami Shores Village County Miami -Dade Zip 3'. \ ??
Is Building Historically Designated YES NO Y\
Contractor's Company Name (if applicable)
Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Walls
Fascia
Drip Cap /drip Edge u�
Soffit (JJ k'
Roof
Flower bins
Shutters
Awnings
Chimney
Doors and door jams
Garage doors
W03
Designer White
2337FB Blanc Deco FB Only
PRATT & LAMBERT
6i02
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 laws regulating construction and zoning.
Signature JUL e
Owner or Agent
APPLICATION APPROVED BY:
P &Ztf j l•
Date
Date
chc 6/18/03
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 8/26/2004
Applicant: NICOLE
Owner: SUISSA
JOB ADDRESS: 35
Contractor
Local Phone:
Parcel # 1132060130240
NE 92
Building Permit
Permit Number: BP2004 -1152
SUISSA
NICOLE
ST
Contractor's Address:
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOTS 15 & 16 BLK 2 LOT SIZE 100.000
Fees: Description Amount
FEE2004 -8664 Building Painting Fee $60.00
FEE2004 -8665 CCF $0.60
FEE2004 -8666 Notary Fee $5.00
FEE2004 -8667 Training and Education Fee $0.20
FEE2004 -8668 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $67.30
Total Receipts: $67.30
Permit Status: APPROVED Permit Expiration: 2/19/2005 Construction Value: $600.00
Work: EXTERIOR PAINTING
Page 1 of 1
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) BY:
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
MIAMI SHORES VILLAGE. FLORIDA
❑ DATE
❑ PERMIT N9 5351
0
e a
Architect
Contractor
or Builder " L' 4
Legal Lot
Description
rp
Work to be performed under this Perthit
t , r
r 7 195 7
Contractor's d
License No.
Subdi-
vision
Address of Value of °
Building a , < - Project $
This permit is granted to the contractor or builder named above to construct the building f or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
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 ac•
Amount of i 0 @�
Permit $ ,y
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR BUILDER c i BY AUTHORITY