780 NE 94 St (11)Date
Type Insp'n
Permit No.
Name
Address
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDINQ DEPARTMENT
305- 795 -2204
Buildjng,Inspection Request
A-c-
st-iabg
-/
cLu.e 1 044.4cA9--
6305) 54 k+1dO
J2/a /o
Name
'MIAMI SHORES VILLAGE
BUIL INEPARTMENT
\ 36'5.-17'9?-2204
,` Building Inspection Request
Date 0 1
Type Insp'n nit V '
Permit No. Pd 0
Tpj -(LA
Address "/ k9 E
Company
Phone # (3 0 .5) 5 eke, — de/JO
%/o L
Inspection Date
Approved
Correction
Re -Insp' n Fee
BUILDING
PERMIT APPLICATION
FBC 2001
Owner's Name (Fee Simple Titleholder)
Owner's Address
City !" kl lAAA 6 C A- . State
Tenant /Lessee Name
Contractor's Company Name
Contractor's Address
$ Value of Work For this Permit
Submittal Fee $
Notary $ - 7) - 00
Scanning $
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
Radon $
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
1U(Pc-
Permit Fee $
Ma r Permit No.
ED 2
Permit Type (circle • Building Electrical -Pitri>Et Mechanical Roofing
ciL
* * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * **
&'O .nC)
Training/Education Fee $ , O
Zoning
Structural Plan Review. $
Permit No.PO I 0 '
Phone # � 09.6 _ "( 6
Zip
Phone #
Phone #
Job Address (where the work is being done) ` J Vv
City Miami Shores Village County Miami -Dade Zip _ l
Is Building Historically Designated YES NO
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
, CJ Square Footage Of Work:
Type of Work: ❑Addition ['Alteration ENew ❑ Repair/Replace ❑ Demolition
Describe Work: P l �T
CCF $ e 60 . CO /CC
Technology Fee $ t - 50 .
Bond $
Bonding Company's Naine (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Naine (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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose pr..e is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the f st i ,pection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will of be at proved and a reinspection fee will be charged.
Signat ure V W Signature
Contractor
The foregoing instrument was a wledged before me this 1 The foregoing instrument was acknowledged before me this
day of , 2kA, by ) l an (K' , day of , 20 by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY UB IC: ivMabut v PUBLIC:
ommission #DDIJ1984 Sign:
, tie s:
Bonded Thru Print:
I inntie Bonding Co Inc
Chc 05/13/03
My Commission Expires:
Owner or Agent
APPLICATION APPROVED BY:
My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
******************************************************t''***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
Miami Shores Village
-y • Paint Color Approval and Agreement
' 4O (
Date --
?P\UL Phone #
Owner's Address L
Zip 33 (
Job Address (where the work is being done) 48a ` L �
City Miami Shores Village County Miami -Dade Zip 331
Is Building Historically Designated YES NO
City 4A.014)--$ State
Contractor's Company Name (if applicable)
Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Walls
Fascia 4)
Drip Cap /drip Edge LA )
Soffit te_
Roof OcK. t — \9 J U ) (-0-(l
Flower bins
Shutters W
Awnings
Chimney N A;
Doors and door jams W
Garage doors L.0
Railings U l *,
Fences ) ( II
Decorative metal l Pc
All brick (simulated or regular) k A-
Stucco banding
Any other stucco features
Accessory Buildings
Other
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
OWNER'S IDAVIT: I certify that all the foregoing information is accurate and that all work will be done m compliance with all
applicable , -ws re:, ating cons' ction and zoning.
Owner uii gent
Signature
APPLICATION APPROVED BY:
(9-c) 97
Date
Date
6-74y
Date
P& Z c icial chc 6/18/03
Building Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2004 -1268
Printed: 9/22/2004
Applicant: ELWOOD HUSTON
Owner: HUSTON ELWOOD
JOB ADDRESS: 780 NE 94 ST
Contractor
Local Phone:
Parcel # 1132060141650
Contractor's Address:
Fees: Description Amount
FEE2004 -9504 Building Painting Fee $60.00
FEE2004 -9505 CCF $0.60
FEE2004 -9506 Notary Fee $5.00
FEE2004 -9507 Training and Education Fee $0.20
FEE2004 -9508 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $67.30
Total Receipts: $67.30
Permit Status: APPROVED Permit Expiration: 3/19/2005 Construction Value:
Work: painting
Legal Description: 5 6 53 42 MIAMI SHORES SEC 3 PB 10 -37 LOTS 6 & 7 BLK 65 LOT SIZE
$500.00
Page 1 of 1
Signed: (INSPECTOR)
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:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: BP2004 -1268
Printed: 9/22/2004
Applicant: ELWOOD HUSTON
Owner: HUSTON ELWOOD
JOB ADDRESS: 780 NE 94 ST
Contractor
Local Phone:
Parcel # 1132060141650
Building Permit
Contractor's Address:
Page 1 of 1
Legal Description: 5 6 53 42 MIAMI SHORES SEC 3 PB 10 -37 LOTS 6 & 7 BLK 65 LOT SIZE
Fees: Description Amount
FEE2004 -9504 Building Painting Fee $60.00
FEE2004 -9505 CCF $0.60
FEE2004 -9506 Notary Fee $5.00
FEE2004 -9507 Training and Education Fee $0.20
FEE2004 -9508 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $67.30
Total Receipts: $67.30
Permit Status: APPROVED Permit Expiration: 3/19/2005 Construction Value: $500.00
Work: painting
Signed: (INSPECTOR)
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: