PAINT PERMIT1.
4
Owner / Lessee
State
** *
Notary as
My Commiss
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address . ,11%25 9°2 / s�
Legal Description l G f /t b � fi O t 6 .087bC. K /O , ya
�.� Ae7i/
/ Tenant ,1 9 4 / /47/ e• (7,94.10.1".7 Master Permit # 37 / 5 5
Owner's Address /4:36 4'4. ; 44.4. /".7f 9 f2 Phone66S) 6s -
Contracting Co. d4'/ 4CC■Cale.
Architect /Engineer f
Bonding Company ♦✓
Mortgagor
Permit Type(circle one
WORK DESCRIPTION
Square Ft. ; S9 /5
Signature of owner and /or Condo President
Date:
K p
oP • ,.� _ » ��O 1
��� 0N E0.
E A
t O to C o 1s 1
9l t .. o4 U LY 24 199y
sident
* *
FEES: PERMIT '3 45 "5i) RADON 14(60
Zoning
Mechanical
Fire
* *
Building
C.C.F. J�
Tax Folio //-- 32 -- 06-- cD/3—p03.
Address 42/
Qualifier f€ / OP 4 SS# ` '/ - Phone
Municipal # Con -`-- , '�b• Ins.Co.
ILDING
ELECTRICAL PLUMBING MECHANICAL ROOPING PAVING FENCE SIGN
'74 0.< 0 na, /f/W /f<Irg
Estimated Cost(value)j4 1 0 U
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 jurisd tion. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, 'OOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing informat'•n is accurate and that all work will
be done in compliance with all applicable laws regulatin: Fiction and zoning. Furthermore, I
authorize the above -named contractor to do the work sta
Signature of Contractor o
Da e:
i
NOTARY TOTAL DUE
Builder
Notary as to Contractor or
My Commission Exp res QFFICIAL NOTAR
ASQUITH LLOYD WRIGHT
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC412849
* * * MY MMISSbt X! . T =
Other
1/ Electrical
I •f
Plumbing Engineering
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF DADE: ?17c 199 FEB 28 14:24
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: SO N L ! Z -S
2. Description of improvement:
3. Owner(s) name and address: 4/..4 7 tai 2 ( C b P"w".2.4�-
/F? , - o , 7 ,oter 1. < ,7
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: 4 C c/ i a / 4) ('r L/ P de--)
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
Si ture of Owner
Pri Owners Name 4iq- 4,,0ryq / �yt�,�• /'c>�s 9r��
Sworn r&d- subscribed before me this 2 7 day of Gee. , 19 i� — .
Notary Public
Print Notary's Name
My Commission Expires:
/
4: 2 / � �..,. C•
of this Noti e of Commencement: (the expiration date is 1 year from the date of recording unless a
cified) ,
P RY
PU OFFICIAL NOTARY SEAL
!, FRANK LOPEZ
AAY C
F OF f∎ O JULY 1995
Prepared by: ,.:-Lk
Address: 0 255Z, tiw / 7.S r
.33/ 2.1'
123.01 -52 2/93
February 25th, 1995
TO: DADE COUNTY BLDG. & ZONING
111 N.W. l st St.
Miami, Florida
Re: Structural Inspection of Roof and Framing for Repair of the
Residence located at 58 N.E. 92nd St., Miami Florida
Owner: First National Mortgage
Dear Building Official:
Per my field inspection of the existing 8" CBS Wall, One -Story Residence at the address
above, it has been found that moderate structural damage was found at two locations of
the roof framing, wood rafters @ 24" o.c. at the South -East corner of the Living Room,
and at the hallway towards the bedrooms. In both cases the problem involves only small
areas. Also, moderate damage was found in a corner of a non - bearing wood partition of
the interior wood framing system, with no danger of a structural failure.
The damage can be repaired by replacing the structural system, locally, by the same or
equivalent system, thus maintaining the original structure. It is hereby recommended that
the immediate area around the problem areas of the roof at the Living Room and
Halwway, be shored before replacement of the same members. The corner with damage
can be replaced without difficulties, since the partition is non - bearing, and other wood
studs take up any loading from wall skins and finishes.
Other than these deficiencies, no structural problems were found, and the entire building
structure is in no danger of collapsing. The residence, with the items above repaired,
should be structurally sound and safe for further repair. Should you have any questions
regarding anything related to this matter, please do not hesitate to call me as soon as
possible.
Sincerely,
NAVACO, INC.
Engineering & Consulting
7
Carlos— : rro, P.E.
P.E. Lic. #35276
NAVACO, INC.
Engineering & Consulting
10532 S.W. 118th Place
Miami, Florida 33186
(305) 595 -9416
File: FNTMI.DOC
February 25th, 1995
NAVACO, INC.
Engineering & Consulting
10532 S.W. 118th Place
Miami, Florida 33186
(305) 595 -9416
TO: DADE COUNTY BLDG. & ZONING
111 N.W. 1st St.
Miami, Florida
Re: Structural Inspection of Roof and Framing for Repair of the
Residence located at 58 N.E. 92nd St., Miami Florida
Owner: First National Mortgage
Dear Building Official:
Per my field inspection of the existing 8" CBS Wall, One -Story Residence at the address
above, it has been found that moderate structural damage was found at two locations of
the roof framing, wood rafters @ 24" o.c. at the South -East corner of the Living Room,
and at the hallway towards the bedrooms. In both cases the problem involves only small
areas. Also, moderate damage was found in a corner of a non - bearing wood partition of
the interior wood framing system, with no danger of a structural failure.
The damage can be repaired by replacing the structural system, locally, by the same or
equivalent system, thus maintaining the original structure. It is hereby recommended that
the immediate area around the problem areas of the roof at the Living Room and
Halwway, be shored before replacement of the same members. The corner with damage
can be replaced without difficulties, since the partition is non - bearing, and other wood
studs take up any loading from wall skins and finishes.
Other than these deficiencies, no structural problems were found, and the entire building
structure is in no danger of collapsing. The residence, with the items above repaired,
should be structurally sound and safe for further repair. Should you have any questions
regarding anything related to this matter, please do not hesitate to call me as soon as
possible.
Sincerely,
NAVACO,1NC.
Engineers >ig'. &:consulting
Car . awl rro, ' P.
P.E:;L,ic. #352 7.6 File: FNTMI.DOC
PROPERTY OWNER
f n o`t' � 7 - ri&sr■
Name COL(Q iu""
1
Address Gq" 1 ( and S
NA Vwt` gie ems -- 3 3
Home Telephone S -1 --M-1-
Business Telephone 2 • S _4413 _..
"(J
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
.In IVII l 1.1.1
.11..111 li.I 1 LIIII1 Ell 1_II I l
INSTRU The following steps must be taken to a permit from the Miami Shores Village:
IIII °I1 I
Step 1.
Complete the attached permit application which must be signed by the property owner and _qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
A PPLICATION
Job Address: �cs 4E, el;rvi S-k (YuaalI S PS 13.i?
Address Apt. City State Zip -
Folio Number 1 D Description of Work QCLtf -X-P�c 4 Inai-A3-(2
Lot
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property I--Vgue of Work kl 2 6C — Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Block
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
PERMIT APPLICATION
Subsidiary Permit No. _bp 'oleo Les .
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
Page 2
I\1I'() NO'T'I
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
A PF I DAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STA F FL Y OF MIAMI -DADE
Si
41.
(27v/ �l�o)
� -
Print Name Ll Print Name
Sworn d subscribed before me this\N day o Sworn to and subscribed before me this day of
SEAL:
01- l•
PERMIT APPLICATION
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
teegfAFl6tiga 4\ t ' :L '_,_ Signature of Notary Public - State of Florida
6
i n SEAL:
�a . ^a:. 1
OR, Produced Identification v Personally known OR, Produced Identification
Personally known /
Type of Identification Produced:
SECTION
DATE
Zoning
' BY
�.�
i
7/,-,2--7A
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
�
Building Official
I
1l Z
Page 4
OFFICE USE ONLY
CHECKLIrST
111111'1'111 1
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
1 1'! 1111 ,11 .1
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $ / v
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoni Review
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
Cl IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ 6
$
0 v
( sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ (V_,c . 4 C
1111111!..P11 1 `6 1
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
ISSUING OFFICIAL
:I
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
ELECTRICAL
TYPE
Minimum Fee
QTv.
Tvi l.:
Dryer
()Tv.
.l.YI.l.
Outlet, Appliance
Q?.Fv.
.LVI,l,
Service Repair
QTY.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
N1 LCI1AN1CAL
Tvi'li
Minimum Fee
QTV. Tvi'i:
Condensate Drain
QI'v. TYPE:
Generator
QTY. ' rvi is QT)
Refrigeration, Tons
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
PLU\1131NG
TVI'l.
A/C Condensate
QTY
n.l,l,;
Drains, Roof
()Ty.
.
Miscellaneous Fixture
QTY
INN.:
Soakage Pit
().1.y.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 3/29/2002
Applicant: QUANY
Owner:
Contractor Address:
Local Phone: Cellular:
Parcel # 1132060130030 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 W1/2 OF LOT 5 & LOT 6 BLK 1 LOT SIZE
Job Address: 58 NE 92 ' ST
Fees: Description Amount
FEE2002 -1840 CCF $0.60
FEE2002 -1841 Notary Fee $5.00
FEE2002 -1842 Building Permit Application Fe*60.00
Total Fees: $65.60
Permit Status: Approved Permit Expiration: 9/25/2002 Construction Value: $250.00
Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
JAMES A. PORTER -BROWN
QUAYNY L. PORTER -BROWN
58 N.E. 92ND STREET
MIAMI SHORES, FL 33138
G R E E N P E A C E
Date
PORTER -BROWN
o r d e r o o f e V 1 ! 1 Q t , 7 L a j2 m o m / S h o r P S is ( 0 6 . ( e 0
BANK OF AMERICA, N.
r..• r nn
Building Permit
Permit Number: BP2002 -651
Page 1 of 1
Total Fees: $65.60
Total Receipts: $0.00
- - «, k,.d,1;nw nr to install the eauipment or device described in the application herefor in strict compliance with all
ns, drawings, statements or specifications that may have been submitted to
i compliance with such ordinances or if the plans are changed without
O 0 er named above assumes the responsibility for a thorough knowledge of the
statements or specifications and that he assumes responsibility for work done
63 -4/630
•ice•
tx For
' n - 3'000f1 L �9 u • 'n n r , , r•h
RiikTro
with all ordinances and regulations pertaining thereto and in strict conformity
In accepting this permit I assume responisibility for all work done by either
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 7 - 23-.02, Time �I
Type Insp'n 4,;i/d 4 7G
Permit No. 2 P ,2M z ° 4t57
Name 7 c 3A4311J
Address 551 Ne 9 Si'
Company 6 7 47 7tee)
Phone # ? L 5" 75 - 2 / 2
Approved
Correction
Re- Insp'n Fee
Garage Doors
Railings
Fences
Decorative Metal
APPROVED:
Building Offi
MIAMI SHO
Paint Color Approval and Agreement
DATE: 2-`l 0 •
OWNER'S NAME: Ws v..4 ET-00t1 J PHONE: .5cfs 7 0S 11.
ADDRESS: v i\ft 2 ° So-ott:s 331
ADDRESS OF SITE: 5 ANA S PAY E.
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
,51G('-. I ibUou)
Walls
Fascia C112=,
Drip Cap/Drip Edge 'r
Soffit
Roof leW : o'f'(V1
Flower Bins f(
Shutters Vi 11 E,
Awnings A
Chimney N\
Doors and door jams P'(a p L
All brick (simulated or regular) A
Stucco Banding 1, A
Any other stucco features O' \,40400w 0 WI L
Accessory Buildings l. c)-
Other
3/ 2 1 G�
e
11
ES VILLAGE
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. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will be as per the attached
sampl-s.
PHONE:
3
ure of Owner Date Signature of Contractor Date
** ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
Flower Bins
Shutters
Awnings
Chimney
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: X / 72C/1" JO. , 9c C -
OWNER'S NAME: 416(P it)2i 2T - - ,a�?aotPHONE:• 30S -7S -C /-;)--
ADDRESS: Y 5 � M& c V - / i 'I cC'/-laZ - S' - PC 3/3e
ADDRESS OF SITE: y- /O °/o/ I' S- f17i //nl efice,r z- ssi
CONTRACTOR & LICENSE (if applicable) ,U / / a
COMPANY NAME: p/y PHONE:
*********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listfd and indicate
Walls IS -1 0 P_€-)e-
Fascia (9o4-0 - /0
Drip Cap/Drip Edge ( 46 -10
Soffit toHiT 0 /
Roof N /t) (c%,t r S- »i � 76r Co 126
10 /F
N/A
Doors and door jams
Garage Doors ph-1
Railings 1,01-I C 0/
Fences (C r'Ym.) ,916 40
Decorative Metal /ofh T7= U /
All brick (simulated or regular) h-
Stucco Banding phi
Any other stucco features acc2-T' :-
Accessory Buildings 0 3in
Other
Building Official Date
I,of -h7E cLOC
�7a /LT 6 7 /l?
leo p
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. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will be as per the attached
saafdles.
C
N
th
th
O
Signa r of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
semolina