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230 NE 94 St (2)3311 -, MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time Name Address r Company hone # \S v For Inspector: 6 (; Name & Date " 1 )#\, E 6 t \f_s47\- Approved Correction ❑ Re- Insp'n Fee ❑ j 331 iIAMI SHORES VILLAGE • BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request D - � ! s Time Type Insp'n-;', -4 , ,N! Permit No. �� 1) Name_ Address Company Phone # For Inspecto ' 0-13 Name & Date Approved Correction Re- Insp'n Fee 1 , PERMIT APPLICATION FOR MIAMI SHORES VILLAGE _ } - Date /0 ,t Job Address Legal Description ' I ' " Owner/Lessee / Tenant 4 2 W , R& sGl/j / Owner's Address 2.3 9 cf' c5 / Contracting Co. . SP,-,,/G -L44 64. /9-4 Address Qualifier 2 AA/LQ _ 41 64 )9. SS# ?_ blhone q La, - r ) . 1 _ State # Municipal # Competency # / (3 03 Ins. Co. (2 R_ A -A) 4' of Al' Architect/Engineer Bonding Company Mortgagor • Sigfi ature of owner and/or Condo President Date Notary as to Owfier and/o My Commission Expires: A. n ' E. 4/10;. .1O 7tt arts (1 F';,mt.".".! ;y ;trawn l 1 War I. D. FEES: PERMIT /'�) d RADON APPROVED: Zoning Mechanical G3© SI Tax Folio /1 —3 :0' — 3 -3‘,30 C.C.F. Historically Designated: Yes No , Address Address Address Building Master Permit # Phone d4 oT Contractor or O NOTARY X 64 1 '7 3 ( 15 3K 5“.) 1 E4- Electrical Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN AC-'PM �•(-tT" - f- �C PAa - ae.. 0f- /e7-5 / �, k o WORK DESCRIPTION ,.t a D ' - C � .0,✓e -k-4 L 4-(c. 4-(c. S yi ¢t -v ,, 1 44tCC / `J t/ Thy 4/e 6s-/ / 2 ( . u0 e Square Ft. Estimated Cost (value) i›2 9 ° o C= 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. .; ?VNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable la regulating construction and zoning. Furthermore, I authorize the above -named co tractor to do the work stated. 7 er "` Not. ! as to Contractor or Owner- Builder My Corrosion Expires; ft Date Date BOND /0 7 �� TOTAL DUE Plumbing Engineering PERMIT APPLICATION FOR MIAMI SHORES VILLAGE '_ Job Address 23 0 AIL 96/ GT , Tax Folio Historically Designated: Yes No Owner/Lessee / Tenant V Sn /T,( Master Permit # l 3 f Owner's Address P- 3 7 /L} 24I .5 Contracting Co. Address Qualifier 0661/CIE.-.a--- SS# Phone State # Municipal # Competency # Ins. Co. Address Architect/Engineer /v' Bonding Company Alf) Mortgagor 1iMr6 /2 05 //. ,16,11)0/4_ Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION , tg /07 I,- T1210) Square Ft. Estimated Cost (value) > 154 cF, ICJ 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 lows regulaj g construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. 9/944 nature of owner and/or Condo President Date Signature of Contractor or Owner - Builder Date Notary as to Owner and/or Condo President Vq/f‘ — ate My Commission Expires: My Commission Expires: -.. .,.spa �P� P , OFFICIAL NOTARY SEAL �� SCOTT W DAVIS y� ,. COMMISSION NUMBER CC255237 7 �F ' c) MY MY COMMISSION EXP. OF `} ./AN. 231997 FEES: PERMIT ("' RADON C.C.F. NOTARY j .4. BOND APPROVED: Zoning Building Electrical Mechanical Plumbing Engineering Address Address Phone /9 758 0e -/2h, &) 7$ TOO ,.6/2 Notary as to Contractor or Owner - Builder Date TOTAL DUE Miami Shores Village BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle)( Building ) lectrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) k'se ` 1nc„ Tilt. Phone # 5O S1 %4 C Owner's Address Z. C ; e C c- (= - ° j .6 6-_ City ` e S State (z (. Zip 3 3 1 3 Tenant/Lessee Name Phone # Job Address (where the work is being done) Z 30 F, '1'1 '41 City Miami Shores Village County Miami -Dade Zip ) 1 3 b Is Building Historically Designated YES Building Department Contractor's Company Name ' i I ) Phone # Contractor's Address City State Zip Qualifier $ Value of Work For this Permit ( /_ .5;00 /A-) /94 Architect/Engineer's Name (if applicable) Architect/Engineer's Address City State Zip Number of: Bays Stories t Families Type of Work: ['Addition ['Alteration ❑New Describe Work: hi_ 't v., k cX - -\— e LC v- (,-) tf 46 \Ac,c,)c Permit No. h Master Permit No. . Phone # `.I OQ90 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 . - i w'ko Square Footage Of Work: Bedrooms, Z Baths Z Repair/Replace ['Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * * s * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 10 County Escrow Fee $ ,. D Permit Fee $ Notary $ ,S , 0 0 Education/Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ • / 6 Struct.$ Minus Plans Check Fee $ Total Fee Now Due $ _c. `o 1 0 (Continued on opposite side) Bonding Company's Name (if applicable) e , 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 i Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 9- The foregoing instrument was acknowledged before me this day of (3 \ J� , 20 05, by Ci )11\161 l )YY) I' � h . , day of - , 20 _ , by who is personally known to me or who has produced ( CUL (.. (Q who is personally known to me or who has produced E NOT Si in : As identification and who did take an oath. as identification and who did take an oath. 0 Gt p z NOTARY PUBLIC: Y ' UBLIC My Commission Expires: Chc7/7 /03 APPLICATION APPROVED BY: A_t, 7 I ° 5 Sign: Print: My Commission Expires: A Po Angela M Becker 4 My Commission DD150048 ?p,/ Exp November 15, 2006 ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. 2003 Plans Examiner Engineer Zoning Miami Shores Village Bate %//3 Owner's Name /jJ /cL /A /GO /Z.Y /7W / Z Phone # 3a-C" ?c -O Y7h Owner's Address c23 /06 95/ City /44/$4 S NHS State F( Zip 33 /3F Job Address (where the work is being done) 0 30 /06 qc City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO I Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Walls 6A-de A-) Fascia W/1 /76 Drip Cap /drip Edge 60/7 Soffit all /%6 Roof AHA Flower bins ` l./A Shutters h3/4 Awnings /2//' Chimney Gl1//��. Doors and door jams W47/6 Garage doors /1.//79 Railings A/49 /t/7 Fences Decorative metal Ai/9 Accessory Buildings Other Paint Color Approval and Agreement All brick (simulated or regular) /V // Stucco banding Any other stucco features "IVA /V /7 Zip * *** * *** * *** * *** * *** * *** * **** * *** * *** * *** * *** * *** ** *** * *** * *** * *** * *** * **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 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 `G - - Date Owner or Agent APPLICATION APPROVED BY: Z • fficial 7/24 Date 2/0 3 Chc6 /1803