Loading...
PAINT42-1(2, OCT 0 o 2005 MIAMI S ORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bui ding Inspection Request Date • 06 Type Insp'n4 j 14 /44— 1 T Permit No. - 103 Name H 42? - -NeN/ LL)i J N Address 3144 M C 95 ST Company ( ©mi 4'E. E- Phone # C 1 c=f _I Z —Z Inspection Date `® 0 . 05 Approved Correction Re- Insp'n Fee Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2005 -1031 Printed: 7/15/2005 Applicant: ANDREW DUBIN Owner: DUBIN ANDREW JOB ADDRESS: 374 NE 95 ST Contractor Local Phone: Parcel # 1132060136060 Signed: (INSPECTOR) Building Permit Contractor's Address: Page 1 of 1 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 W25FT OF LOT 2 & ALL LOT 3 Fees: Description Amount FEE2005 -9708 Building Fee $60.00 FEE2005 -9709 CCF $0.60 FEE2005 -9710 Training and Education Fee $0.20 FEE2005 -9711 Technology Fee $1.50 Total Fees: $62.30 Total Fees: $62.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 1/8/2006 Construction Value: $2,000.00 Work: ENTERIOR PAINTING 'JUL 19?A 1Tc 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: w• Permit Type (circle): Owner's Name (Fee Simple Titleholder) Owner's Address City / ( 4- Tenant/Lessee Name .5110 I -_5 State $ Value of Work For this Permit Total Fee Now Due $ (Continued on opposite side) Z . 30 Miami Shores Village Building D epartment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. S 1 Q3 1 PERMIT APPLICATION n Master Permit No. FBC 2001 E ct 'cal Plumbing Mechanical Roofing s'jcvvn '064.t o Phone# , 92 Jc -6C. r _. t- C _.., Zip 3 ( 'iP Piet,. : A, L5 Phone # -j Job Address (where the work is being done) j 7( A' r. CI L • 5() e: C- (-- City Miami Shores Village County Miami -Dade Zip 133 f - j - ?1 Is Building Historically Designated YES NO Contractor's Company Name ()cone( • Phone # Contractor's Address City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # ,2 COO .00 Square Footage Of Work: AID Type of Work: ❑Addition 'Alteration ENew ❑ Repair /Replace ❑ Demolition Describe Work: {i✓ /'/ a' r _ I �C� t! ****************************F Submittal Fee $ Permit Fee $ (Q0 CCF $ E7 • (::::O CO /CC Notary $ Training/Education Fee $ b 20 Technology Fee $ 1 •S • Scanning $ --- Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) N /A Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N I ftr 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be • • -, and a reinspection fee will be charged. 7 Owner or Agent Contrac#or The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 1( , 20 6, by , day of , 20 _, by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. Signature Signature NOTARY PUBLIC: Sign: Sign: Dp Print: `J c4 reill k1 My FeriOlint: Pahick L Commission Expires: ����• :i . `¢'= Commission Y P G _ CAri►mi y Commission Expires: fir Jun 16, 20 ******* * * * * ** * * * * * * * * * * * * * ** * * * * *** * ** * * * *E *$ 2�r un f+ gmy * ** * * * * ** * * * ** * * * * * * * * * * * * * * * ** '" i i l ' Atlantic Bonding Co., Inc. OTARY PUBLIC: ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: chc 05/13/03 4 71 0/05 Plans Examiner Engineer Zoning t .. Signature APPLICATION APPROVED BY: Miami Shores Village Paint Color Approval and Agreement D ate °'� n ,, Owner's Name J 3 i c b \ 4i to Owner's Address 3 1 X9.6'^ 964 C , Ci ty (lIa.rvl t 5 iO re State Pc— Zip Walls ero,2 - u---k- Fascia Drip Cap /drip Edge Soffit l Roof UJi (44 19k, p 0.tiol?e,(9., Flower bins AJ )3 Shutters Awnings Chimney Doors and door jams Ah l< Garage doors 1'f 1 A Railings Af 1A• Fences p.)(40. Decorative metal 6+� All brick (simulated or regular) n11A Stucco banding Any other stucco features e%' Accessory Buildings A1/4 39'f ilr. 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) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Other ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** OWNER'S AFFIDAVIT: I certify that all fo = oing information is accurate and that all work will be done m compliance with all applicable laws regulating construction and • nin .. . er or Agent P& Z Offici Phone # .3313- 6s) 99a- 163(o Zip ( 331 Braid Nut 2OYY 63 Date / OT chc 6/18/03 dat I �1( oryA b (4 ► 0 being the legal property owner, for the property Located at: 37g 1\f, Q-i S"(' 714( % SS+ores J CL 33/3 , 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),And I have read and understand the following disclosure Statement, which entitles me td 3.Erork as my own contractor, I further understand that I as the owner anust 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. J You may also build or improve a commercial building at a cost of 525,000.00 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 Iicensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with- 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. Proof of ownership provided ( ) Was acknowledged before me,this t of C , 20 IN a Ot;l sa d P „BG, ;ssion :1;231984 o. . ns Co li' 3 2007 r who is personally nown ar �tlaslu , p y �.. _ _ Nr, a ondedThN M/ 9 .. lijoniondinQ�O h . �'O F� as identification and who did take an oath. By Produced OWNER BUILDER DISCLOSURE STATEMENT _ VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT DISCLOSURE STATEMENT initial of reviewing clerk. The foregoing instrument BUILDING 4 }t' PERMIT N:' 4257 PLUMBING Lot Architect Contractor or Builder Legal Description MIAMI SHORES VILLAGE, FLORIDA DATE 1f 194_6 Work to be performed under this Permit Owner of .- Building Bl. Subdi- vision Contractor's License No. f e(.? it L t1 ft Address of = Value of 1 Amt. of Building < "" ... r te ` ti er , _'' , „ " Project Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in Tie appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with tkny plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents; servants or employees. f r Signed: L. . •) . t , By INSPIrcTbR 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, servant or employee. BY AUTHORITY