PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 0 03 1 l- "rl c ST • Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant / 1 / ►4 �-e o4/ '
Owner's Address /0 DS 96- S7
Contracting Co. 0/02 �30 I deele Address // /7 7
Qualifier e/9.4)c .e /de "iv P2
State #
Architect/Engineer Address
Bonding Company Address
0) 77OUSe 4 e- x0 ,0/7
Notary to Owner and/or Condo President
My Commission Expir s°" - '6'f i Muter 5FA �'I My Commission E
tl GIADYSi VII .iAR
:44.)TPak? t trniiC '57 411; OF II r ).?1.l i
FEES: PERMIT RADON
APPROVED:
Zoning Buil
Mechanical Plumbing
' NOTARY
Master Permit # 2 157 /p
Phone 737— 33,
Phone f ,pr 2
Municipal #30 -0 a3 / Competency # 6 // 3 S L Ins. Co. Ll S /-6
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION �2e'SScC &(9 / /9-,-/c/ ✓ - iEe/ 7
/1/ t to l/v 1 / 7 ,
Square Ft. Estimated Cost (value) 9
Electrical
00
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYNG 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 jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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. Furthermore, I authorize the above -named contractor to do the work stated.
<
Signa ndo Pres 4 -nt Date / Signatur f Contr ct r or er- Builder
Date No as to Contractor or Owner - Builder
i• - , ` r .OTAYS
GUM VILIAR
MAW MAX STATE OF >FIZDA
COl'a tSKON CC714103
I n 4 kiik446 C1'1 EXP. Ma. 8
e
Date
BOND
TOTAL DUE Vt. --.6-2
Engineering
Owner's Name and Address
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein
described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the
State of Florida. all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether
herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work.
( Y� f 3 ITT eA M c J O R -
5C 5
Registered Architect andior Engineer /� �� ��
Name and address of licensed contractor ...0e /�- /� 7 I ^° �� `" '
Location an / legal descr' tion of lot to be built on:
Lot /ZW a 4/ 10 Block / Subdivision Wilee i / .0 o6 " 4 .5%
0
Street and Number where work is to be done io o' C - pJ- j "�i
State work to be done and purpose of building (by floors). state exterior colors (submit samples) / / /
Ex`ri /O, ,-a/../-- /,J / � / /6
and for no other purpose
New Building Remodeling Addition Repairs 7 No of Stories 1
To be constructed of �y� Kind of foundation Roof Covering
Estimated Total cost of improvements S / G' / � J /fir/ / Re Amount of Permit S 5 ' NO
Zone cubage required Plan Cubage -
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
1 hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to --
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's
Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement. and has complied with the provisions thereof. and will require similar
compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit: and will post or cause to be posted for inspection
on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks I Signed I
STATE OF FLORIDA
COUNTY OF DADE. ss.
Before me. the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known.
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application. and that he did sign the same. and that all facts therein by him stated are true.
Date / /A7e,
Permit No. 2 f S
Disapproved Date
Notary Public, State of Florida
(Signed)
Chairman Member _.
Member Member
Member Member
Council Approved 1 ate Disapproved Date
NOTE: A charge of 525.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
A re- inspection fee of 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship.
Building Inspector My Commission Expires
PLANNING BOARD DATE
Read. Sworn to and Subscribed before me.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date I I C �job Address 1 uo (Vs" 6 )4 - S7 Tax Folio h 0 t 3 S �o
Legal Description M. S• a ® lc' 17 "T1, NI "/. Lo- 19 cl) - $) l- LTS I•.Ir - - ysyc. ly.)-.
Owner / Lessee - rennint 14 �` e-(3ca -T S97.44 J J Master Permit # -3l
Owner's Address / Phone - 74 --- 7-,3(.9 - / -
. 54
Contracting Co. �6cDG� A/'lE� <! /C ;'',e4/9Address 1 h ; < /Y'c� �� ' 3 �
Qualifier i4/ '/ / ‘ c 6 : ; " SS# Phone "57 ` F,/',33
a Z .1 . 44- '7 404( - 17-1
State # Municipal #.203g9.2 Competency # 0000/7C331ns.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor
Permit Type(circle one): BUILDING
WORK DESCRIPTION
Square Ft. fq.wt..)
Signature of owns
Da g/e2 a.c ,�
Notary as to Owner
My Commission Expi
** * * *
1 00ctia- r�5i
. / 4 - c 1
ELECTRICAL
and / Condo President
/99
and /or Condo President
res:
NOTARY PUBLIC STATE OF FLORIDA
MY COMMISSION EXPIRES 5/09/94
Bided thru Etembier ldams &iSweet
Address b) O f ox 01 Y- i i vb►; q 3► a�
S yog
FENCE SIGN
PLUMBING MECHANICAL ROOFING PAVING
Estimated Cost(value)
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 jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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. Furthermore, I
authorize the above -named contractor to do the work stated.
* * *
` Signature of Cont
Date:
FEES: PERMIT ... Y(5 6 RADON C.C.F. 1 415 NOTARY 1 TOTAL DUE
APPROVED: Fire
Zoning Building
Mechanical Plumbing Engineering
rac
ire
Notary as to Con
My Commission Ex
0 0
or Owner- Builder
G RAMSA 1 CUNDIFF
p COMMISSION NUMBER
CC252686
MY COMMISSION EXP.
* * F F03 JAN. 12 1997**.
Other
Electrical
Date 1 6 9 7 Job Address I o 0 A I c 51
Legal Description P I rt.-„ A-tsS Sr C .3 P
,Leseee-/—Tenast viceAter S P,4 4A) Master Permit # ? ?5S7
Contracting Co. �E(,' /Q 74/NT /''✓7 ( T J Address 5- 4/ 2 /
Qualifier I1► /dPLz c SS# - Phone S - eS 3 3
State #
Architect /Engineer /T
'
Bonding Company N,/I Address
Mortgagor kt S t-{O)C_ Address
Permit Type(circle one): BUILDING ELECTRICAL
Owner's Address
WORK DESCRIPTION
Square Ft. (4- 0 8 e) Estimated Cost(value
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 jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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. Furthermore, I
authorize the above -named contractor to do the work stated.
Signature of of trier a4ld /or Condo President
dtt-
Date:
Notary o Own= and /qtr C,f o President
My Commission Expires:
s O
FEES: PERMIT 3 7
APPROVED:
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
11d■E
4� 1 f
M ietpal a 6 3890) -S Competency 0000/7433 Ins .Co .4$$Oe /A ri oN .CA/Pce /ezJ
PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
E - rE,e o ,e./ 7A / A/ T/ n/ C ( J/ /
/� /0 i 7j 7e
�p.RY Pv6 OFFICIAL NOTARY SEAL
O S u <1 RAISA I CUNDIFF
COMMISSION NUMBER
a CC252686
COMMISS N rXP.
OFF AN. 121997
RADON C.C.F. /
Mechanical Plumbing_
Tax Folio dJ- -O 1 y4 - 3y 7 O
(-07 17 bN/ L 0-r 1-'7 ec-1-
Address
Signature of Contr
Date: 3//4, S'
Notary as o Contrac
My Commission Expires.
* * *
00
NOTARY
Phone
tor or Owner- Builder
�pS F OFFICIAL NOTARY SEAL
o 7 <i RAISA I CUNDIFF
• } T ;� COMMISSION NUMBER
Q CC252686
9t �O MY G�ppMMISSIO XP.
`c 0F F JNN. 12 1 Z
TOTAL DUE L I3. S-
Other
Electrical
Engineering
N
Inspection Number: INSP -18852
Permit Number: PT -6-06 -1480
Inspection Date: 06/13/2006
Inspector: Grande, Claudio
Owner: SPAHN, HERBERT
Job Address: 1005 95 Street NE
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Monday, June 12, 2006
Miami Shores Village, FL 33138-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number (305)757 -2368
Parcel Number 1132060143570
Lot:
Page 1 of 2
Passed 1 67/3/ 0
( l c
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
N
Inspection Number: INSP -18852
Permit Number: PT -6-06 -1480
Inspection Date: 06/13/2006
Inspector: Grande, Claudio
Owner: SPAHN, HERBERT
Job Address: 1005 95 Street NE
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Monday, June 12, 2006
Miami Shores Village, FL 33138-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number (305)757 -2368
Parcel Number 1132060143570
Lot:
Page 1 of 2
Qualifier Name
Permit Type (circle):
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING IrV'
Permit No. P PERMIT APPLICATION �fl� 1 !Va s Permit No.
FBC 2004
B Y:
Electrical Plumbing ) Mechanical Roofing
Owner's Name (Fee Simple Titleholder)) it Hz-AA ,' 5pA 0) j-Pn e # .> [.9 4 - 7 - - i-3 c P
Owner's Address C b 0 4i ,,I,.( c 5 i
City / A. Pl ( 5 /-/ d R e tate F c—
Tenant/Lessee Name
Job Address (where t wart - is1 n* done) / a b 4 l'ik Zl i 5 —7
City Miami Shores Vi e County Miami -Dade Zip ') / 3
FOLIO / PARCEL #
Is Building Historically Designated YES NO t�
+Or e CLkyle
Contractor's Company Name 14 r62 13 p -r C Phone # 47 5 - 7 C 7 – 5 G�
Contractor's Address
City State Zip
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 0 0U Square / Linear Footage Of Work:
Type of Work: ❑Addition ['Alteration Repair/Replace ❑ Demolition
Describe Work: pit b 5 v f t, rieY - PA / /\-)-)" 6`}4 7 & i 1 U y�
/DT ° Til G If -oor \\ )
***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ ,00 CCF $ 1 ,.49 CO /CC
Notary $ Training/Education Fee $ ® .00 Technology Fee $ Q • .
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ b.E3 .
AN 01 k1
Zip - 23. 1 3
Phone #
Phone #
See Reverse side --�
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 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.
1 Signature
NOTARY PUBLIC:
Owner or Agent
The fore oing instrument was acknow , dged � before me this
day of C y
20Ceb 1 1� r rl J hl JY of
who is personally known to me or who has pr uced I CI who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
My . ission Expires:
APPLICATION APPROVED BY:
(Revised 02/08/06)
Ce//°
The foregoing instrument was acknowledged before me this
20 , by
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Plans Examiner
Engineer
Zoning
.•
Date G Ji�o G
Owner's Name r4 e -(0->>Lr -r A Al `J Phone # u — - 7 S - 3 C )-'
c
Owner's Address
City M /)'r iv)i hi- ° P-r5 State F-L._ Zip ) 3 y
Job Address (where the work_beingdo
City Miami Shores Villas County Miami -Dade Zip
Is Building Historically Designated YES NO 1/
Contractor's Company Name (if applicable)
Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
V
V
Walls
Fascia
Drip Cap /drip Edge
Soffit
Roof l)
Flower bins
Shutters
Awnings
Chimney
Doors and door jams
Garage doors ✓
Railings Ad
Fences IV
Decorative metal
All brick (simulated or regular) jJv.
Stucco banding
1 4 Signature
Miami Shores Village
Paint Color Approval and Agreement
N�
Any other stucco features 't)
Accessory Buildings I� J
APPLICATION APPROVED BY:
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.
/ bb/ v a C Li
'�.
P& Z Officia l
Attach Color Samples
With Numbers
W1 17�
Date U / 6 4
Date
chc 6/18/03
Issue Date: 6/1/2006
Owner's Name: HERBERT SPAHN
Permit Type: Paint
Work Classification: New
Job Address: 1005 95 Street NE
Comments:
EXTERIOR PAINTING
Additional Information
Miami Shores Village, FL 33138-
Building Department File Copy
Applicant Signature
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 11/28/2006
Contractor(s) Phone Primary Contractor
HOME OWNER
Yes
Type of Work: Exterior Color: WHITE
Additional Info:
Classification: Residential
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 responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: PT -6 -06 -1480
Phone: (305)757 -2368
1132060143570
Lot:
PB:
Total Square Feet: 0
Total Valuation: $ 3,000.00
Required Inspections
Final
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology Fee
Total:
Amount
$1.80
$0.60
$5.00
$60.00
$1.50
$68.90
Invoice Number
PT - 6 - 06 - 25035
Total:
Amt Due
$68.90
Amt Paid
$68.90
$68.90
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.