969 NE 92 St (4)Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
• Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
ir.i Owner's Name (Fee Simple Titleholder) / < % p f" if '/-?/: . 6 'S� 5 Phone # � i/7/ / ` 2 7 -' e7
,�
Owner's Address t r 2 --= . /u' r le( (6'
City ./... l' ',4/.2.1' State . -2 / Zip S / (
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 9 7 A, z /z % l —
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
. /f
Contractor's Company Name V : r--- Phone #
Contractor's Address // l ? : -, / l� / 6 :' , (' /
City / J C 6 'f- / '- State 4( Zip
Qualifier ie . . ' yam r� / ` e"`'�
Architect/Engineer's Name (if applicable) -- Phone #
S Value of Work For this Permit /
Type of Work: ❑Addition; " 7 [Alteration
Describe Work: ki
Submittal Fee $ Permit Fee $
Miami Shores Village
** *A * * * * * * * * **** *** ** * * *** Fees * * * * ** * ** *,p lc* * * * * * * * * * * ** * * **
Notary S `` ` Training/Education Fee $ f Lie
Scanning S ' C a� Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due S
(Continued on opposite side)
Master Permit No.
Square Footage Of Work:
Zip
'd t
['New ❑ Repair/Replace ❑ Demolition
'-
CCF S t ;�' CO /CC
Technology Fee $ )
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 approved and a reinspection fee will be charged.
Signat ur/) 11
`�
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 _ , by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY:
Chc 12/15/03
Signatur
The foregoing instrument was acknowledged before me this )3.
day of ' r !% , 20(5L, by
who'ipersonally known to me or who has produced
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
*************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ontractor
as identification and who did take an oath.
�t, .... ,
3, 2337
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
ect
Walls
Signature
APPLICATION APPROVED BY:
Miami Shores Village
Paint Color Approval and Agreement
Owne 's Name 7&/f/5' /02 i� � 5S
2 / /�4 ' / �
Owner's Address /i ?5
City State P 1.4 Zip 3 3 /&
Job Address (where the work is being done) 1 9 6 r ii 2 5 ' 7--
City Miami Shores Village
Is Building Historically Designated YES NO
Contractor's Company Name (if applicable) Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
5 7 7 , 4. 5
Fascia �../" �! WC'
e �
Drip Cap /drip Edge
/ �
Soffit
Roof
Flower bins ;<b;/ Shutters Awnings �j ,
Chimney /&//
Doors and door jams /41 /((( � ; - T
Garage doors / ,' / /!2
Railings 1V7
Fences /�4-
Decorative metal /,
All brick (simulated or regula
Stucco banding
Any other stucco features
Accessory Buildings
Other ei
* * * * * * * * * * * * * * * * * * * * * ** **************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
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.
Owner or Agent
P& Z OfErcial
Phone # 7r
County Miami -Dade Zip
111
shooting star
304
Date
Date d g /d7
chc 6/18/03
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n '-1 c �
Permit No.
Name -Af.
Address -
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
7i 4 %
o
0
f �'�' vI
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: BP2004 -37
Printed: 1/15/2004
Applicant: MICHAEL MEYER
Owner: MEYER MICHAEL
JOB ADDRESS: 969 NE 92 ST
Contractor RJM BUILDERS
Local Phone: 786 853 - 8807
Parcel # 1132060060031
Permit Status: APPROVED Permit Expiration: 7/11/2004 Construction Value: $1,200.00
Work: EXTERIOR PAINTING
Signed: (INSPECTOR)
Signed: (Contractor or Builder)
Building Permit
BY:
Page 1 of 1
Contractor's Address: 1859 N PINE ISLAND RD STE 113
Legal Description: GOLDEN GATE PARK AMD PB 7 -54 LOT 3 LOT SIZE 50.000 X 140 OR 18936 -0487
Fees: Description Amount
FEE2004 -304 Building Painting Fee $60.00
FEE2004 -305 CCF $1.20
FEE2004 -306 Notary Fee $5.00
FEE2004 -307 Training and Education Fee $0.40
FEE2004 -308 Technology Fee $1.50
FEE2004 -309 Scanning Fee $3.00
Total Fees: $71.10
Total Fees: $71.10
Total Receipts: $7110
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.
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: BP2004 -37
Printed: 1/15/2004
Applicant: MICHAEL MEYER
Owner: MEYER MICHAEL
JOB ADDRESS: 969 NE 92 ST
Contractor RJM BUILDERS
Local Phone: 786 853 - 8807
Parcel # 1132060060031
Permit Status: APPROVED Permit Expiration: 7/11/2004 Construction Value: $1,200.00
Work: EXTERIOR PAINTING
Signed: (INSPECTOR)
Building Permit
Page 1 of 1
Contractor's Address: 1859 N PINE ISLAND RD STE 113
Legal Description: GOLDEN GATE PARK AMD PB 7 -54 LOT 3 LOT SIZE 50.000 X 140 OR 18936 -0487
Fees: Description Amount
FEE2004 -304 Building Painting Fee $60.00
FEE2004 -305 CCF $1.20
FEE2004 -306 Notary Fee $5.00
FEE2004 -307 Training and Education Fee $0.40
FEE2004 -308 Technology Fee $1.50
FEE2004 -309 Scanning Fee $3.00
Total Fees: $71.10
Total Fees: $71.10
Total Receipts: $71.1
,P
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: