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BP-05-159Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/18/2005 Applicant: TOUSHA Owner: COX JOB ADDRESS: 42 Contractor Local Phone: Parcel # 1131010170200 NW 92 Building Permit Permit Number: BP2005 -159 COX TOUSHA ST Contractor's Address: Page 1 of 1 Legal Description: 1 53 41 CANADY EXTENSION PB 41 -71 LOT 19 LOT SIZE SITE VALUE OR Fees: Description Amount FEE2005 -4961 Building Painting Fee $60.00 FEE2005 -4962 CCF $0.60 FEE2005 -4963 Training and Education Fee $0.20 FEE2005 -4964 Technology Fee $1.50 Total Fees: $62.30 Total Fees: $62.30 Total Receipts: $62.30 Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $700.00 Work: PAINT HOUSE EXTERIOR 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 PERMIT APPLICATI FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) 4 42, AAA. a City M I t State Zip 5*(-) 1 < Tenant/Lessee Name Phone # , S - - 3 325 Owner's Address ■ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name Contractor's Address City rn A fti Qualifier State Certificate or Registration No. Certifica. of Competency No. Architect/Engineer's Name (if applicable) - Phone # $ Value of Work For this Permit 700.00 Type of Work: ['Addition ❑Alteration ['New ❑ Repair/Replace El Demolition Describe Work: t� 1k l Q 11 -lino W AS dosed in nee Cl Re- IFlolt51'1 grierfo2 'Wall u.ltr A Rough 1! rI(S ieN . A-' c( Acid( LA CC-0 b AeV in C, -o Pl P'o 4 LA ind04.A.) C' 0 t.A vv. in Or\ x'(0,14` 70 c.h sae Vi !rider 4-r) Total Fee Now Due $ C (Continued on opposite side) 3 0 Miami Shores Village Building Department RECEIVE. N73 1 2 2095 Electrical * * * * * * * * * * * * * * * * * * * ** C-®) Phone # * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit No. C 1 Master Permit Plumbing Mechanical Roofing Ob5 1f --4gz 1 q County Miami-Dade Zip 3-3160 NO Phone # -hog -151 4 G) 42 iN uFl 02, State E e Zip 33151: (6n4/1/41 Square Footage Of Work: Iv- Submittal Fee$��' Permit Fee $ (U , 06 CCF $ ' GO CO /CC Notary $ '' � ��-) Training/Education Fee $ Technology Fee $ 1 •Q Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) e el Bonding Company's Address City State Zip s` 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. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of 20 Wby'r® u- , who is NOT Sign: Print. My Commission Expires * * * * * * * * * * * * * * * * * * * * * i_fll ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * APPLICATION APPROVED BY: Chc 05/13/03 me or who has produced As identification and who did take an oath. Signature Contractor 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: 0%0414,4, Lawanda Warren E xpires April 6, 2007 Bonded Thrn h?: G My Commission Expires: Plans Examiner 0 l Engineer Zoning Date 05 Owner's Name Signature A APPLICATION APPROVED BY: Miami Shores Village Paint Color Approval and Agreement [ " s io ' Coy Phone# 3 O`J '25 Owner's Address L2 ( t/J - Z� 5f rl City 1 I Y j State 'l(?(.Q S I" 1: Zip 3 31 S ) Job Address (where the work is being done) City Miami Shores Village County Miami Dade Zip Is Building Historically Designated YES NO Name (if applicable) Phone # Contractor's Company PP � ) ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Walls Fascia Drip Cap /drip Edge 9 Soffit Roof Flower bins 3 fit a Shutters Awnings Chimney 1 Doors and door jams 9t \Li h t Garage doors Railings w l• 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 • I d zoning. Owner or Agent 0,4 2 1 Body: Pale Sagebrush ECC -38 -1 2 Trim: Icy Tundra ECC- 38 -2' 3 Accent: Sea Fern ECC -38 -3° Date Date Date OS Owner's Name O()S (+ft e0v Phone 305 — ` '7 5) -2 / bg 1 Owner's Address 42_ !Qi' qz-' City M I ■1 1 State F1, Zip 331S" C) Job Address (where the work is being done) 1 1 S City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Name (if applicable) Phone # Contractor's Company PP � ) ************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * *'* * * *. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ��tb -- a listed and indicate t @ i t !i ainted All e W Arai alls Fascia Drip Cap /drip Edge Soffit Roof t1 p Flower bins 3 Shutters Awnings Chimney Signature APPLICATION APPROVED BY: Miami Shores Village Paint Color Approval and Agreement Doors and door jams Garage doors 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. 1 Owner or Agent P& Z Official Child iSt‘ 8\ ° C Attach Color Samples With Numbers a 1"‘ 3 O 0 14 Date 1 — a Date chc 6/18/03 OWNER BUILDER DISCLOSURE .STATEMENT ekt Located at: Produced VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT Owner Owner being the legal property owner, for the property a rv. Ui. G2 DISCLOSURE STATEMENT Proof of ownership provided ( ) initial of reviewing clerk. Tlie foregoing instrument Was acknowledged before me this o - , 20 1 who is o me or who has Legally described as ' Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S. 489.103(7),.nd I have read and understand the following disclosure Statement, which entitles me td 3Vork as my own contractor, I further understand that I as the owner must appear in person to complete all applications. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. 'You must supervise the construction yourself. You may build or improve a one - family or two-family residence or a farm out - building. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and frith- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. • as identification and who did take an oath.' a �, ,� o yaw anda Warren (1-1!.:6114f1 e <<;. Commission # a =P kprd1 : ae Sonded $tu •114.....`)q' t ic Bonding s OW- ♦ ALlan ConIII� Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/18/2005 Applicant: TOUSHA Owner: COX JOB ADDRESS: 42 Contractor Local Phone: Parcel # 1131010170200 NW 92 Signed: (Contractor or Builder) Building Permit Permit Number: BP2005 -159 COX TOUSHA ST Contractor's Address: Page 1 of 1 Legal Description: 1 53 41 CANADY EXTENSION PB 41 -71 LOT 19 LOT SIZE SITE VALUE OR Fees: FEE2005 -4961 FEE2005 -4962 FEE2005 -4963 FEE2005 -4964 Description Building Painting Fee CCF Training and Education Fee Technology Fee Total Fees: Amount $60.00 $0.60 $0.20 $1.50 $62.30 Total Fees: $62.30 Total Receipts: $62.30 Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $700.00 Work: PAINT HOUSE EXTERIOR 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. BY: