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PAINTBUILDING _ PERMIT APPLICATION FBC 2001 Permit Type (circle): (Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) 4'u �( v Phone # oS2ggyn z Ownerr' Address ) D'o M E q4J 5 City '1" a ,Q.CpS r State ceL Zip 3311 Tenant/Lessee Name 4/A- Phone # Job Address (where the work is being done) pLcE q4 ST City Miami Shores Village County Miami -Dade Zip 331'4 Is Building Historically Designated YES NO Contractor's Company Name Phone # Contractor's Address City State Zip Qualifier Architect/Engineer's Name (if applicable) M / I $ Value of Work For this Permit Total Fee Now Due S FCt C. i rl Ul (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No PO 705 Master Permit No. * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 0 CCF $ 0 CO /CC Notary $ S., © Training/Education Fee $ Technology Fee $ f is Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Type of Work: ❑Addition ['Alteration ['New ❑ Repair/Replace ❑ Demolition Describe Work: ! 4 C4 (Q)140)) Phone # Square Footage Of Work: Bonding Company's Name (if applicable) Bonding Company's Address b 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. Signature or Agent The foregoing instrument was acknowledged before me thi day of 20 + ,t who is personally known to me or who has produced 1 - L� 2,,.y.3) *Sr "t 1 1 Ibis identification and who did take an oath. N TAR Y,' PUBLIC: \ j NOTARY PUBLIC: Si /( A V, Sign: P t:, i_l. Print: My Commission Expires: My Commission Expires: ****** it* ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holdler) State Certificate or Registration No. Certificate of Competency No. ******;******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** yak************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** JUL 21 2004 APPLICATION APPROVED BY: Chc 12/15/03 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. Plans Examiner Engineer Zoning Roof N, Flower bins ,0/14. Shutters /�' Awnings Chimney Doors and door jams Garage doors AS/tf Railings Fences Apt Decorative metal Miami Shores Village Paint Color Approval and Agreement Date y � ,,/ /� ��� py� Owner's Name f1J &(Q.l C,G�'Vit" (,�LIJt�.a h �'"�""` Vim'" Phone # 3 05,2.9 0 d7-< Owner's Address < ) � f O /V ' sr City � I AM. � �4grecS State F. Zip 3Wg g Job Address (where the work is being done) 1 ZOO ,0C / V 5r City Miami Shores Village County Miami-Dade Zip 3 / 37 Is Building Historically Designated YES NO ✓ Contractor's Company Name (if applicable) i) / ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Walls (Ea dde c T (D atiA 629 °6 =3 Fascia Catigiotedry, CZ Drip Cap / / 19/+ Soffit - fGR•(a9f( gide, CO O f- All brick (simulated or regular) Stucco banding P. iki- Any other stucco features 46c- Accessory Buildings F APPLICATION APPROVED BY: ehlr S ao P& Z Official Phone # aeA 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. Date .701 Date chc 6/18/03 Date Mar ,�b�� Owner's Name a Mar kOAkwAkoupt ""' "' Phone # Owner's Address 1 0 /0C q City t- £ 6 W� State FL Fascia ' Drip Cap /drip Edge Soffit )0,)"..f/—. Roof s r-2 l c 5 kLIA Flower bins Shutters Awnings i Chimney - : 3 Doors and door jams Garage doors Railings Fences Decorative metal Stucco banding Any other stucco features Accessory Buildings Other APPLICATION APPROVED BY: Miami Shores Village Paint Color Approval and Agreement Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name (if applicable) ************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate th Walls `6 ? F er All brick (simulated or regular) o Grave, P& Z Official Zip 33- f 3 Zip Pt�oi # Date Date * * *;?t " * * * * * ,** * * * * * * * * * * * * * * * * * * * ** colorip be painted chc 6/18/03 ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 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. • Paint Color Approval and Agreement Date Owner's Name Owner's Address City Shutters (■.) 19 Signature (de State p! Drip Cap /drip Edge NI Soffit�L ekk D. Roof , Flower bins /0/4 APPLICATION APPROVED BY: Miami Shores Village Job Address (where the work is being done) / POO /l/lL City Miami Shores Village County Miami -Dade Zip 33/ Is Building Historically Designated YES NO v Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted 0 al Owner or Agent P& Z Official gti Phone # �1� Zip 33/j/ A Samples Awnings )0 e Chimney \,IiWWY\Q `t'" 1 Doors and door jams Garage doors Railings Fences 8� Decorative metal - OM - All brick (simulated or regular) 2 Stucco banding Any other stucco features 1J Accessory Buildings p 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. Date Date #3 Bill To None None Return to: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Date Fee Name 07/27/2006 RENEWAL Thursday, July 27, 2006 Invoice Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Invoice Number: imp -7 -06 -25716 Invoice Date: July 27, 2006 Permit Number: BP2004 -705 Fee Type Calculated Total Fees Due: Fee Amount $35.00 $35.00 , Payments Date Pay Type Check Number Amount Paid Change 07/27/2006 Check 1852 $35.00 $0.00 Total Paid: $35.00 Total Due: $0.00 1 r sr a BUILDING PERMIT APPLICATION cw Master Permit No. FBC 2004 Permit Type (circle): Building E1ec al _K. Plumbing Mechanical Owner's Name (Fee Simple Titleholder) A' I &fi r �j ejTid /2 Zr/44 one # Owner's Address )200 /OE Qy Sr City -1 SIAIDMS State FL Zip 3313c Tenant/Lessee Name Job Address (where the work is being done) City FOLIO / PARCEL # Miami Shores Village Is Building Historically Designated YES NO IC Contractor's Company Name Contractor's Address City State Qualifier Name State Certificate or Registration No. Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: ['Addition Describe Work: Submittal Fee $ Notary $ Scanning $ Bond $ Miami Shores Village Building Department 10050 N.E.2nd Avenue 4 iami Shores, Florida 33138 Tel: (305) 795. 41 : (305) 756.8972 0 _ e §9 'N °`) ['Alteration )too Ave sr County Miami -Dade ['New €4C erior or 4-42 ke , e * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Structural Review. $ * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ S ' CCF $ Training/Education Fee $ Radon $ DPBR $ Phone # Phone # Permit No. 0* Phone # Square / Linear Footage Of Work: ❑ Repair/Replace Total Fee Now Due $ Roofing 3:5 ,,9fr99-7- Zip ,3/.r 5 Zip Phone # Certificate of Competency No. C O /CC Technology Fee $ Zoning $ Code Enforcement $ Double Fee $ See Reverse side --� 11 Demolition 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. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,20by , day of ,20,by who is personally known to me or who has produced 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. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 02/08/06) Plans Examiner Engineer Zoning Date . - I2/o1O(0 Owner's NameAktagicipr ` eittesiciolv atictisiar Phone # ?S2.4 FA ?- Owner's Address 1Z.10b Al 6 ''( Sr Ci ty State rL Zi p Job Address (where the work is being done) 1200 S4JE 9y 57` City Miami Shores Village Is Building Historically Designated YES NO A Contractor's Company Name (if applicable) /U /4 All elements on the site must be listed and indicate the color to be painted Walls 1 Fascia Drip Cap /drip Edge 2 Soffit Roof Flower bins Shutters Awnings 2 Chimney 1 Doors and door jams Garage doors 1 Railings Fences County Miami -Dade Miami Shores Village Paint Color Approval and Agreement Decorative metal /L All brick (simulated or regular) `1( 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. Signature APPLICATION APPROVED BY: Owner or Agent P& Z Official Zip 3513? Phone # Date Date chc 6/18/03 Inspection Date: 0911812006 Inspector: Desharnis, George Owner: ZALDIVAR, ALEXANDERIGWENDOLYN Job Address: 1200 94 Street NE Miami Shores Village, FL Project: <NONE> Contractor: Building Department Comments Friday, September 15, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 26808 Permit Number: BP2004 -705 SEP 1 9 2006 Block: Permit Type: Imported Permit Inspection Type: PAINTING Work Classification: Paint Phone Number Parcel Number 1132050100230 Lot: Page 1 of 2 Passed Inspector Comments cl---1 'Pa---k-__. Failed d - c c Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 0911812006 Inspector: Desharnis, George Owner: ZALDIVAR, ALEXANDERIGWENDOLYN Job Address: 1200 94 Street NE Miami Shores Village, FL Project: <NONE> Contractor: Building Department Comments Friday, September 15, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 26808 Permit Number: BP2004 -705 SEP 1 9 2006 Block: Permit Type: Imported Permit Inspection Type: PAINTING Work Classification: Paint Phone Number Parcel Number 1132050100230 Lot: Page 1 of 2 MOAN SHO F ES VOLLASE BUILDING INSPECTION DEPARTMENT. APPLICATION FO r• UDLDONG PC Application is hereby wade for the npproval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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. Date ... _ ..._ 5-14-76 K+tamx Fred C. Kuhns 1200 N E ° 4th St. O wner's Name and Address _ _ No .............._....__. Stree4._._ 9 .._ Registered Architect and /or Engineer Name and address of licensed contrsctorBiscayne Roofing Co. 180 E. 11th Ave. Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 1200 N.a..a__9 a State work to be done and purpose of building (by floors) _..__ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories _ To be constructed of Kind of foundation Roof Covering built-up and gravel 40 °00 roof repair° s Estimated Total cost of improvements $ Amount of Permit $L k __ q Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the 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 obligations 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 i pection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such s tractors, on work to be performed under this pennit, as are licensed by Miami Shores Village. - J Remarks._._ (Signed) _..�. MOT STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. / Permit No.__ /Q / 5 Date S / ' 5 - . 6.___ Read, Sworn to and Subscribed before me. Disapproved _ Date .._..___...__._. _ _._ / /f (Signed) / .. - 4- Building Inspe r My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Chairman Member Member Member Member ...... Member ...._ Council Approved Date Disapproved Date NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for ingpectica or faulty materials and /or workmanship. Owner's Name and Addrestg,l i/ Iv S y® a iv Registered Architect and /or Engineer 1 Building Inyp4ctor M8 ICI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPUI CA1'I :•° NI F® L D L[ B N r E MOT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mianii 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 Mianii 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. C f Name and address of licensed contractor Ow 14 Location and legal description of lot to be built on: Lot Block - Subdivision Street and Number where work is to be done ...I. 0.C2 r 9 V- S T State work to be done and purpose of building (by floors) G Z o ST A ' �2�.1.T -1 OIt �,S'-- - -- ./�'� /.�7/ fU � Pi ` , 19 .(E�� + ) Nola. 0 CJ Street tlJ i E ..�3...e ° Date Notary Public, State of Florida and for no other purpose. New Building Remodeling Addition Repairs No. of Stories � To be constructed of d " C l? -) Kind of foundation Roof Covering Estimated Total cost of improvements $.30.0 o Amount of Permit $ vu '— Zone cubage required Plan Cubage Distance to next nearest building - -- Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the 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 obligations 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 po ed for inspection on the sitcof e work such public notice or notices as are required by the Act. The undersigned agrees to employ only s subcontractors, on woo tpi be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 s(:abb t@d e. t(ue. Permit No iiSS Date C Read, Sworn to and Subscribed before me. Disapproved - (Signed ) My Commission Expires ANNING BOARD DATE Chairman l 1 Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained from the Planning Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. PERMIT APP Date , /// Job Address fa vv Legal Description /i I __ z j Y i a 1 /Lessee / Tenant l /V/" g( Owner's Address Contracting Co. O .c.. / A- l C (12.- Qualifier SS# Phone State # Municipal # Competency # his. Co. Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUIILDING ELECT CAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN ( "I WORK DESCRIPTION -?* 101 s owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT 3/3l/ 14-1 cally Designated: Yes Master Permit # y 2 ( ei — Phone (7 5 / V'C Address Address Address Address u too p . (= l (o v■-/' 058 hR IC (4. — t.0 I-LTr– (co E Ent) .A2or».+.O ut ►nnrc-tS t DooR. D c)43' Square Ft. Estimated Cost (value) . o 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 : ork will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -nam- • 4 ntracto o do the w. - stated. Irture of Co : actor or Owner - Builder Notary as to Contractor or Owner- Builder Date My Commission Expires: Electrical � SANPRA V3 MOVIE!. O @Mlit3SIOR1 NUCaDEI 1C401201 t^anSStON EXP. W.3^ 17 1000 C.C.F. • NOTARY SP BOND Date APPROVED: Zoning Building Mechanical Plumbing Engineering