870 NE 92 St (3)Da e
Type Insp'n
Permit No.
Name
Address
Company
Phone #
•
MIAMI SHORES VILLA
BUILDING DEPARTME
305- 795 -2204
Building Inspection Request
Inspection Date S
Approved
Correction
Re- Insp'n Fee
MIAMI - SFIORES VILLAGE
BUILDING DEPARTMEI(IT
305- 795 -2204 \ \.-
Building Inspection Request\
Date
Inspection Date .) r
1 f
Approved a � I f
Correction ❑
Re- Insp'n Fee ❑
') /i 2 ' f
Type Insp'n / j, A\ e ;-
--
Permit No. t")
c)
Name _
Address
Company 1 '' 1 ;vi
Phone # 7 t0
k
BUIL�NG
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building , Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) i Lii" "T( (tYU ( Phone # — J ' � F5
Owner's Address (, 1�E
Cit j'v't l `( ir" S State
1Vliami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Tenant/Lessee Name Phone #
Job Address (where the work is being done) frt 0 (i 6 1 9111 C f re "e_
Cit Miami Shores Village County Miami -Dade Zip J 1 C
Is Building Historically Designated YES NO
IN ( Total Fee Now Due $ 10
(Continued on opposite side)
City F L iv,, a State
Qualifier / \ C i t & y � � (' 6 \
$ Value of Work For this Permit CI
Master Permit No.
Zip
_
Contractor's Company Name � I': � ;�� C��� �'�- �� 1 1 � � t+o'�Phone # ( L ,J —'
Contractor's Address J yJ S �'y » �� ` r
V Zip
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
Permit No J 9 v
Type of Work: EAddition ❑Alteration ❑New ❑ Repair/Replace
❑Demolition
Describe Work: --1 6 / I e: ) � .6( "Mir; (r Y
* * * * * * * * * * ** * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ b 0 , CCF $ / ) ) 0 CO /CC
Notary $ S _ d b Training/Education Fee $ ,. q 0 Technology Fee $ 1 t .S 0
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
pell
t 'ill CC
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 b approve. • a reinspection fee will be charged.
Signature
The fore
day of
NOTARY P
Sign:
Print:
Chc 12/15/03
i
/ Owner or Agent
ng instrument was acknowledged before me this 11
20
O4by 7-11( P(Y V
wlikisosonally known to me or who has produced 4Q (L
My Commission Expires:
APPLICATION APPROVED BY:
Mabel Vargas
31984
„ Expires: uI 13, 2007
OF ' Bondedl'hru -
Contracto C�
The foregoing instrument was ackno 1 dged before me this
, 20 O C.�by Mct!l ik O, �� 1,t
day of
who tersonally know to me or who has produced
As identification and who did take an oath. as identification and who di e an oath.
NOTARY P
Atlantic Bonding Co., Inc. My Commission Expires:
****************************************************************************i 4",4 4,*** *ib7flkMi fYIX=4**ntfc*****
r °• �'; Commission #0021526/
kt Expires: May 26, 2011:
� Bonded Thru
State Certificate or Registration No. Certificate of Competency Atlantic Bonding Co., Inc.
(Certificate of Competency Holder)
6,/ti -
Sign: 4
Print:
***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** `j ************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
MAY 1 2 2004
Plans Examiner
Engineer
Zoning
Miami Shores Village
Date
` • ' Paint Color Approval and Agreement
Owner's Name
Owner's Address _
City t V fl
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES NO
o soi
County Miami -Dade Zip
r iks 2 U n-11 Phone # 3 6 - vi '7153v l
Contractor's Company Name (if applicable)
i
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Flower bins
Shutters
Signature
Walls
Fascia
Drip Cap /drip Edge
Soffit
Roof
Awnings
Chimney
Doors and door jams
f
/
APPLICATION APPROVED BY:
Owner or Agent
I
1
1
AHorh f nlnr Samnleg
Garage doors j?� w
Railings Ai A
Fences /0 4
Decorative metal )Q A-
All brick (simulated or regular) (A. U v ` :j -[ e
Stucco banding
Any other stucco features
Accessory Buildings
Other
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
OWNER'S AFFIDAVIT: I certit all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regula '. g construction oning.
?
L Date
cial
O
O
Date 6
moonlight
chc 6/18/03
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/12/2004
Applicant: TINA PORTNER
Owner: PORTNER TINA
JOB ADDRESS: 870 NE 92 ST
Contractor PRESTIGIOUS PAINTING
Local Phone:
Parcel # 1132060050140
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2004 -626
Contractor's Address:
Page 1 of 1
Legal Description: GOLDEN GATE PARK ADDN PB 6 -130 LOT 3 & E1/2 LOT 4 BLK 2 LOT SIZE
Fees: Description Amount
FEE2004 -4869 Building Painting Fee $60.00
FEE2004 -4870 CCF $1.20
FEE2004 -4871 Notary Fee $5.00
FEE2004 -4872 Training and Education Fee $0.40
FEE2004 -4873 Technology Fee $1.50
Total Fees: $68.10
Total Fees: $68.10
Total Receipts: $68.10
Permit Status: APPROVED Permit Expiration: 11/7/2004 Construction Value: $1,500.00
Work: EXTERIOR PAINTING
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: