PAINTMiami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2004 -1344
Printed: 10/18/2004 Page 1 of 1
Applicant: GUSTAVO & SHEILA LOPEZ
Owner: LOPEZ GUSTAVO & SHEILA
JOB ADDRESS: 575 NE 95 ST
Contractor
Local Phone:
Parcel # 1132060140760 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOT 22 & W1/2 OF 23 BLK 54 LOT SIZE 75.000
Permit Status: APPROVED Permit Expiration: 4/10/2005 Construction Value: $300.00
Work: EXTERIOR PAINT
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.
Contractor's Address:
Fees: Description Amount
FEE2004 -10016 Building Fee $60.00
FEE2004 -10017 CCF $0.60
FEE2004 -10018 Training and Education Fee $0.20
FEE2004 -10019 Technology Fee $1.50
Total Fees: $62.30
Signed: (INSPECTOR)
Building Permit
Total Fees: $62.30
Total Receipts: $62.30
®t1 1 a Qua
Signed: (Contractor or Builder) BY:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10/18/2004
Applicant: GUSTAVO & SHEILA
Owner: LOPEZ
JOB ADDRESS: 575 NE 95
Contractor
Local Phone:
Parcel # 1132060140760
•
Signed: (INSPECTOR)
Signed: (Contractor or Builder)
Building Permit
Permit Number: BP2004 -1344
LOPEZ
GUSTAVO & SHEILA
ST
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 4/10/2005 Construction Value: $300.00
Work: EXTERIOR PAINT
BY:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOT 22 & W1/2 OF 23 BLK 54 LOT SIZE 75.000
Fees:
FEE2004 -10016
FEE2004 -10017
FEE2004 -10018
FEE2004 -10019
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Total Fees:
Amount
$60.00
$0.60
$0.20
$1.50
$62.30
Total Fees: $62.30
Total Receipts: $62.30
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.
Miami Shores Village
Paint Color Approval and Agreement
' ( 4 �(
Date
Owner's Name J��
Owner's Address 5 !vC
City ILA, atAA, Sh6v7-5 State
Decorative metal
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated ( NO
Contractor's Company Name (if applicable)
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Garage doors
Railings
Fences
Signature
S bd
Walls
Fascia W ► \f It -Gl,i l .
Drip Cap /drip Edge
Soffit
Roof
Flower bins
Shutters
Awnings
Chimney
Doors and door jams / v _ � I S I N& 6
A-
County Miami -Dade
All brick (simulated or regular)
Stucco banding
Any other stucco features
Accessory Buildings
Other
Atflei'llarita•° Ref
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
applicable laws regulating construction and zoning.
APPLICATION APPROVED BY:
P& Z Official
Phone # 3 s '7S 7 U I
Zip 3313
Zip 3 (
Phone #
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Date
Date
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be done mpliance with all
4 /0/07
chc 6/18/03
HC-1 28
Date_
Type Insp'n
Permit No.
Name
Jv
- 13p
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204 aI\
Buildir}g Inspection Request !\
Address
Company
Phone #
Inspection Date
Approv
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Oc-f ( C4 R S To 1 ec�
FO 1
S ' 2 • cP 5
pL
CP
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 95' Job Address 5 ' Tax Folio
Legal Description Historically Designated: Yes No
S - /y /4)29 A e /Z.7
Owners Address 575 7 'S7
Owner/Lessee / Tenant
Contracting Co. DZi) /1/
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
P' S: PERMIT 11 0 RADON C.C.F.
Address
Master Permit # 3 ei SD Z)
Phone 7S6 —6 C 3
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
y� U 5 SN�+�d
WORK DESCRIPTION /7�/�r / /D� — iT��/ tz/i9Z2 �� �/4
-4 -74967
Square Ft. �/// //l/��//Y Estimated Cost (value) - j 0 (), d d
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.
Date
.¢§161f4pftEgICIAL NOTARY SRAL
0 ! SANDRA Pa I1ORITILL
N ��., , COMMISSION 9B6y DEW
y, ;.so,
,,,, r. 0, Can oommISSION .EXP.
� OF Fi e AUG. 99 IAeEI
Notary as to C
My Co
Date
NOTARY Cc TOTAL DUE _ [ v '
APPROVED:
Zoning Building 1) Electrical
Mechanical Plumbing Engineering