1099 NE 96 St (5)-MIAMI SHORES LU'AGE
BUILDING DEPAR'MENT \
305 -795 -2204
Building Inspection Request
Date
Type Insp'n k f� v' t�e .� V
„ i o 4
Permit No. 2 &q- 35a .
Name l!( ) hL
Address 10 ( I C I i 0v t0 ,5 •
Company 14 CC1 .
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee ❑
MIAMI SHORES \ LLAGE
BUILDING DEPARTMENT \kk
305- 795 -2204
Building Inspection Request
Date
Type Insp'n rI p t..,aI i0d
Permit No 6e 20 "1 �J .
Name I XJ )10 1 .
Address iq zK qC 5
Company PACY t'"' .
Phone #
Inspection Date
Approved
Correction
Re-Insp'n Fee
•
MIAMI SHORE , iJJGE
BUILDING DEPAIMENT
305- 795 -2204
Building Inspection Request
3S�
Date
Type Insp'rq
Permit No. - ) t _J
Name
Address 1 01 7 ( 1 6
Compan
Approved
Correction
Re- Insp'n Fee
Phone #
Inspection Date
MIAMI SHORES LAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date ! 0
Type Insp'
Permit No.
Name
1 / Q
Address 1 v
Compan
Phone #
Approved
Correction
Re- Insp'n Fee
(, U__)„*„
1 •
3 05' A 1
Inspection Date ) j O
Y
Qualifier
Code Enforcement $
(Continued on opposite side)
ir Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
Miami Shores Village
Permit Type (circle) Building ` lectrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) ._5/1r, - / y' / e/S -S Phone # � �5 � arec: ��
Owner's Address /0 9 9 ////. 96. . Sire B
City 4"1, <<m State / /o» e.
Tenant/Lessee Name
Job Address (where the work is being done) /0 f /L . ,4• _a-,e 1
City Miami Shores Village County Miami -Dade Zip -5 :3 /3
Is Building Historically Designated YES NO
Contractor's Company Name 47)e // go-045 Phone # qx)
Contractor's Address 9 IS' /1. k. J Aetr -G
City /X .-i ?' State / Cwt Zip
G'l is J. /4e-//
Architect/Engineer's Name (if applicable) '' Phone # —�
$ Value of Work For this Permit 1 Zc
Type of Work: ❑Addition ❑Alteration New
Describe Work:
************************** *Fees * * * * * * * * ** * * * * * * * * * * * * * * * **
O r CCF $ • T� CO /CC
Technology Fee $ ) , .S
Bond $
Submittal Fee $.SDA o 2 Permit Fee $
Notary $ Training/Education Fee $ 1 ' DI a
Scanning $ Radon $ Zoning
Total Fee Now Due $ R J 1
Structural Plan Review. $
Permit N D
Master Permit No.
Zip .33/3'f
Phone #
Square Footage Of Work: 64-6
�Repai eplace ❑ Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City
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.
Owner or Agent
The foregoing instrument was acknowledged before me this
Signature
day ofWA
who is personally known to me or who has produced Vi
NOT
Sign.
Print:
TUBL
My Commission Expires:
APPLICATION APPROVED BY:
Chc 12/15/03
State
r✓
As identification and who did take an oath.
RLENE J. MOBLEY
EXPIRES: February OS, 200$7 d
OP
1400 .3.NOTARY Pt. Notary pi at Alio& C,
********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Signature
NOTARY PUBLI
Si
Print:
My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
?//Vvy
Zip
Contractor
The for going i strument was acknowledged before me this
day of , 20 by
who is personally known to me or who has produced
as identification and who did take an oath.
MAR 11 2004
******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
Soffit
Flower bins
Shutters
Awnings e Chimney 7 /
Doors and door jams /V,
Garage doors ,, / /1//1
Railings /// /,
Signature
Miami Shores Village
Paint Color Approval and Agreement
Date / / PJ /
Owner's Name _5% `4/ ° i- Phone # � 'ES /' 4.S6 z/
Owner's Address /?,- 9(,
City//.am; i fhr r'a State /747 -fa/ Zip J.1 )36 `
Job Address (where the work is being done) "b 7'? 4 " 'b .s%
City Miami Shores Village County Miami -Dade Zip 33 / 7 g-
Is Building Historically Designated YES NO
Contractor's Company Name (if applicable) /47 /?7(.21)::.5 Phone # 6Q0.JZ 6
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
/ All elements on the site must be listed and indicate the color to be painted
Walls / "
Fascia i it �, //
Drip Cap /drip Edge /v/
S�-me- ers e--> k5 (ohm /VP)
/i
/t1 II
Attach Color Samples
With Numbers
Fences ti //I
Decorative metal /1/
All brick (simulated or regu ar) /i/ /4
Stucco banding ti/
Any other stucco features /l/ //7
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 regulating construction and zoning.
Date / /c. G �
Owner or Agent
APPLICATION APPROVED BY: CJ`s Date 3 //,‘ (0
P& Z Official chc 6/18/03
Miami Shores Village
10050 NE 2nd Avenue
Building Permit
Phone: 305 - 795 -2204 Permit Number: BP2004 -352
Printed: 3/19/2004
Applicant: SHIRLEE WEISS
Owner: WEISS SHIRLEE
JOB ADDRESS: 1099 NE 96 ST
Contractor ANGELL ROOFING
Local Phone: 305 - 324 -1166
Parcel # 1132060143650
Contractor's Address: 918 NW 7TH AVE
Legal Description: MIAMI SHORES SEC 3 PB 10 - 37 LOTS 1 & 2 BLK 82 LOT SIZE IRREGULAR
Fees: Description Amount
FEE2004 -2869 Building Painting Fee $60.00
FEE2004 -2870 CCF $0.60
FEE2004 -2871 Training and Education Fee $0.20
FEE2004 -2872 Technology Fee $1.50
Total Fees: $62.30
Total Fees: $62.30
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 9/11/2004 Construction Value: $200.00
Work: PRESSURE CLEAN AND PAINT ROOF OFF WHITE (EXISTING COLOR)
Signed:
(INSPECTOR)
Page 1 of 1
BAR 2 2 PAID
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: