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BP-03-1732Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 C [ Fax: (305) 756.8972 BUILDING - 03 Permit No. OP63°1-73J- PERMIT APPLICATION` --as er Permit No. FBC 2001 City /' State • Architect/Engineer's Name (if applicable) Architect/Engineer's Address City $ Value of Work For this Permit .2� " Permit Type (circle): uildin Electrical Plumbing Mechanical Roofing Phone # C.3os) ?/- y 73 Owner's Name (Fee Simple Titleholder) J ' / r / 7 e_ Owner's Address /6C Al a/ 93 S¢- Tenant/Lessee Name Phone # Job Address (where the work is being done) /6f A/GU 93 St ' City Miami Shores Village County Miami -Dade Zip 3A /mod Is Building Historically Designated YES NO 1• ----- i "cl, Contractor's Company Name ey/ / 7 Phone # Contractor's Address / Y / 76 /L/, /32) . City /7, 4 i// / State Zip 3 34/ / Qualifier 1'it J/� 2--- V Number of: Bays Stories Families Bedrooms Type of Work: ❑Additionn ['Alteration :New ❑ epair/Re • ace ❑ Demolition Describe Work: f' _ e a it Zip 35/ Phone # State / Zip Square Footage Of Work: Baths * **** ** * *** *,�*** * **** * * * * ** *F * ** * ** * * *** ** * * *a * * * ** ** * * • County Escrow Fee $ \ . 6 0 Permit Fee $ CO 0 0 0 Notary $ , • ' Education/ Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ (Continued on opposite side) As identification and who did take an oath. • NOTARY PUBLIC: Sign: Print . Expires 30, 2006 gm sum= egm � My Commission E Atlantic Bonding co., Inc. cha7/7 /03 U1)11111111,11.11 et; 1' Bonding Company's Name (if applicable) Bonding Company's Address City State - Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Sta 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. S i g n a t u r e / f 4 l/ Owner or Age��1�� The foregoing instrument was acknowledged before me this33 day of(5142 , 2cP by /'76r Lei •iiee , who is personally known to me or who produc Signature ********* s * * *+r * * * * * * * * * * * * * *s * * * * * * * * * ** *ors * * * * * * ** * * * * * * * * * * ** APPLICATION APPROVED BY: / //S 703 Contra • or The foregoing instrument was acknowledged before me this5 day of 2002, by who is personally NOTARY PUB Sign: Print My Commission Expires: wn to me or who has produced identification and who did tak Atlantic (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. nc. * * * * * * * * * ** ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** NOV - 6 2003 Plans Examiner Engineer Zoning 1VIIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: /0 OWNER'S N AIV15 ADDRESS: / 65 93 Building Official PHONE( d2/- - -�f 73y O3 * * * * * * * * * * * * * * *: ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE S1f�!:� 3 CONTRACTOR & COMPANY NAME: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed a a indicate the color to be painted. Walls t/ .le Fascia o 9 ro Drip Cap/Drip Edge a o . Soffit Go 4 - pi , fii Roof w./ ., Flower Bins 4) h 0 Shutters ,G� � 4 li• rn Awnings w a l � �` H Chimney /P/# ° H Doors and door jams X• i6; z Garage Doors Cv ‘ ‘-/e/ j o Railings g/¢ c g Decorative Metal /s) / . IS, N Stucco Banding Ad/ A 114° All brick (simulated or regular) ,10//1 ISO Any other stucco features Ai 11,— Ike,90/°/ Accessory Buildings ot,i_ PHO •" rif 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 samples. wti�.•• *0/(3 Cdr /- //e Date • Signa e of Con , : ctor Date Sign re of Ov�r� gn D ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Date 4/23/01 MIAMI SHORES VILLAGE Paint Color Approva} aid Agreement DATE: OWNER'S NAME: / o r PHONE: i f 9/- (t-/ 739 ADDRESS: /6 r 114e/ 9. ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site st be listed and indicate the color to be painted. Walls /C Fascia Drip Cap/Drip Edge "v/ Soffit Roof 1 Flower Bins Gv Shutters iv/ Awnings APPROVED: Building Of „ Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal All brick (simulated or r _ular Stucco Banding Any other stucco features Accessory Buildings Other // icial Date cu n c manchester tan 1B n HC -81 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 samples. Signature of Owner Date Signature of Contractor Date *********************************** * * * * ** * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/6/2003 Applicant: Owner: JOB ADDRESS: 165 Contractor COMPLETE HOME PAINTING Local Phone: 305 - 895 -1368 Parcel # 1131010330840 NW 93 Signed: (INSPECTOR) Building Permit Permit Number: BP2003 -1732 ST Contractor's Address: 1476 NE 130 STREET Permit Status: APPROVED Permit Expiration: 4/28/2004 Construction Value: $2,500.00 Work: EXTERIOR PAINT Page 1 of 1 o_t Legal Description: MIAMI SHORES SEC 6 PB 10 -39 LOT 16 & W1/2 LOT 17 BLK 133 LOT SIZE Fees: Description Amount FEE2003 - 6965 Building Fee $60.00 FEE2003 -6966 CCF $1.80 FEE2003 -6967 Notary Fee $5.00 Total Fees: $66.80 Total Fees: $66.80 Total Receipts: $0.00 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: sS