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PAINTDate! ? Signature of owner and/ r Condo President Atie Notary as to Owner and/or Condo Presiden! My Commis FEES: PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address • 7 . 1 ) JAL NOTARY SEAL ARLENE WEAVERLING NOTARY PUBLIC STATE OF FUr, ' ,, COMMISSION NO. CC::9 ' MY COMMISSION EXP. SEPT 2n.! ) 3 Mechanical Plumbing 340 9S 2v z' Tax Folio Legal Description f Historically Designated: Yes Owner/Lessee / Tenant 4e!il B /s f Owner's Address 363‹ /(1 9S Phone Contracting Co. eO f Woe 1 Qualifier R q4'C €. �.e r4t/•ei /� - SS# State # Municipal # b 2 3 /c 3 Competency # Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION F4...(44141-4-e- 4 tee pat V Square Ft. Estimated Cost (value) .5' 3 O, o -1.) 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. RADON Date / /G - I1 Date C.C.F. APPROVED: Zoning Building 11)'17;11 Master Permit # No -, 7 -c ry Address / rti / - / • 7 9 / sr • 'I11 �3 Phone g s 7 y O - 2- /f 3,.r -Ins. Co. 6( S /= � Signature of Contractor or Owner- Builder NOTARY Electrical Notary as to Contractor or Owner- Builder OFFI L NOTARY SEAL ARLENE WEAVERLING NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC390429 MY COMMISSION EXP. sEPT 20,1990 TOTAL DUE Date /; - 7 Date . Engineering f i nspection Number: INSP -4789 Inspection Date: 01/03/2006 Inspector: Grande, Claudio Owner: PALOU, NORA Job Address: 362 95 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: Building Department Comments Friday, December 30, 2005 Inspection Worksheet Miami Shores V illage 10050 N.E. 2nd Avenue M,ami Shores, FL Phone. 05)795 -2204 Fax: (305)756 -8972 Block: Permit Number: BP2004 -1354 J Permit Type: Imported Permit Inspection Type: PAINTING Work Classification: Paint Phone Number Parcel Number 1132060136070 Lot: Passed 1410 C Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 2 of 2 BUILDII` PERMIT A FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) r Phone # t IC� -/ Owner's Address Via. t 1 S O City /)'1L 71. State `t✓ Zip Type of Work: EAddition Describe Work: Total Fee Now Due $ (1 - 1 1 1\ 6kie-Y Aar Miami Shores Village Building Department Tenant/Lessee Name Phone # Job Address (where the work is being done) 3o) kg; 1 -141 City Miami Shores Village County Miami-Dade Zip 3 3 1 3 U is Building Historically Designated YES NO ❑Alteration ores, Florida 33138 D5) 756.8972 Permit No. SPN I3 Master Permit No. / 3)' ECEII ED l OC 1 4 2004 Contractor's Company Name CO- ' iQ Phone # Contractor's Address City State Zip Qualifier State Certificate or. Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit 0 0 0 Square Footage Of Work: ****************************F Submittal Fee $ Permit Fee $ l� V% CCF $ . (pV CO /CC Notary $ 5 - W Training/Education Fee $ , LC) Technology Fee $ 1 • ) Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ (61.30 ek Joao (Continued on opposite side raid ( pp ) ❑K P-7. w CI R//iLk- r/Replace ❑ Demolition , 6-c 4A C,: Bonding Company's Name (if applicable) Bonding Cotrtpany's Address City State Zip Mortgage Lender's Naive (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 joh 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 foregoiin g. instrument was acknowledged before me this 14 The foregoing instrument was acknowledged before me this day of Ce k , 20 Ly, by Kb(V201 patU ' , day of , 20 , by who is personally known to me or who has produced 1 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 P : LIC: Sign: Print: My Comm' ion Expire * * * * * * * * * * * * * * * * * * * * * *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * ** * * APPLICATION APPROVED BY. Chc 05 /13/03 iViat)cr argaTARY PUBLIC: •& • 4 Commission iiDD2319 Si xpir 2001- g Ronded "fhnt Print: tlanUc Bon tn e In.. ************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** My Commission Expires: *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** OCT 18 ZTh Plans Examiner Engineer Zoning Miami Shores Village � Paint Color Approval and Agreement Date ' , f ro _ �. p .s - 611-10 Phone # (c3 S J 3) — £3 d I Owner's Name t "" " Owner's Address 46 A,16 1 City 1"� '' / State It Zip ..33/3p Job Address (where the work is being done) o t0 c City Miami Shores Village County Miami -Dade Zip 3 3 / S f Is Building Historically Designated YES Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted �pp e ������yy 6/34 Walls !V .�-�tJl, �'`�� Fascia •' )Z / 6 /� r Cap/drip Ede 0 )/�Z.i �J 6/34 Drip Cap P g 14 t0 ) 3 7 Soffit ` Roof Signature APPLICATION APPROVED BY: Owner or Agent NO Flower bins Shutters Awnings Chimney 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 re: tin: construction and zoning. P& Z Official Date Date 1 0 //.VO f° chc 6/18/03 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10/18/2004 Applicant: MICHAEL Owner: BROWN JOB ADDRESS: 362 Contractor Local Phone: Parcel # 1132060136070 NE 95 Signed: (INSPECTOR) Signed: (Contractor or Builder) Building Permit Permit Number: BP2004 -1354 BROWN MICHAEL ST Contractor's Address: Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 4 & 5 Permit Status: APPROVED Permit Expiration: 4/12/2005 Construction Value: Work: PAINT #d 8 PASO BLK 45 LOT SIZE 100.000 Fees: FEE2004 -10193 FEE2004 -10194 FEE2004 -10195 FEE2004 -10196 FEE2004 -10197 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $60.00 $0.60 $5.00 $0.20 $1.50 $67.30 Total Fees: $67.30 Total Receipts: $67.30 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: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /18/2004 Applicant: MICHAEL Owner: BROWN JOB ADDRESS: 362 Contractor Local Phone: Parcel # 1132060136070 NE 95 Signed: (INSPECTOR) Signed: (Contractor or Builder) Building Permit Permit Number: BP2004 -1354 BROWN MICHAEL ST Contractor's Address: Permit Status: APPROVED Permit Expiration: 4/12/2005 Construction Value: Work: PAINT BY: Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 4 & 5 Pavhf BLK 45 LOT SIZE 100.000 Fees: FEE2004 -10193 FEE2004 -10194 FEE2004 -10195 FEE2004 -10196 FEE2004 -10197 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $60.00 $0.60 $5.00 $0.20 $1.50 $67.30 Total Fees: $67.30 Total Receipts: $67.30 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.