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PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date f 3- / 6, Job Address • / 2 G/ A ! L '7 _Sr: Tax Folio Ritez, A/-t ••■ Signature of owner and/or Condo President Notary as to Owner and/or Condo President My Commission Expires: FEES: PERMIT 1 RADON Date Legal Description A VE Historically Designated: Yes No Owner/Lessee / Tenant VIA/1" 1 /• v A /(/ t ) Master Permit # 7 Owner's Address / Y A E, q- 9/ I Phone 3 &S- 7 Sa ` Q o 0 5g -3 � yO Contracting Co. / d V /A75 h•-. Address /vim 'j Ptil E We Qualifier SS# 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 WORK DESCRIPTION i' P/ iq r v. Rd D Square Ft. Estimated Cost (value) Se Gf 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 zonin ermore, I authorize the above -named contractor to do the work stated. z3 /1A, k2r� Signature of Ckmtractor or Owner - Builder 0 C.C.F. v S NOTARY APPROVED: r k 1 Zoning Building Electrical Phone TOTAL DUE /0 . Date Mechanical Plumbing Engineering Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n (2 .)k 6P2003- I636_ Name Cad F let Address Cli - 12,4 / J 6 16 , 5 1 Company Phone # Inspection Date t "MIAMI SHORES VILLAGE BUILDING DEPARTMENT - 305 -795 -2204 Building Inspection Request Date ' • Type fnsp'n Permit No. 1 W� 2 00 3 Name ' ,- (7 ! I I r1 s j( r 1 A t , f 7 c/ / Address � 4 , -;1:i � � 7 d l i (� s' • Company -- - -- Phone # Inspection Date Approved Correction Re- Insp'n Fee Miami Shores Village Building Department r EC IE O a/ g�p E 0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Nov 2 2013 BUILT N � PERMIT APP : CATION FBC 2001 Permit Type (circle):C Buildin Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) `c P { . \\ Q , Phone # 7 $ G - 'Z- 5 2 2- S s Owner's Address \ 2 E (A I tk V• S4 City \\I\ c\--_r oy State L - Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) ' `� Permit No. r Er ?COS - l Master Permit No. City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name `-' °' \\ "� "` Phone # - ( 2- 2 - L Contractor's Address \'2 . \\v City \ State V L Zip 3 3 \ 3 O Qualifier \ k"Ni� s � �. (NN. °vim Architect/Engineer's Name (if applicable) Phone # kit $ Value of Work For this Permit '3 C d 0 Square Footage Of Work: Type of Work: ['Addition ['Alteration 4 \ ❑New ❑ Repair/Replace ❑ Demolition Describe Work: q' , �,.� ©V. s`- {= Submittal Fee $ Permit Fee $ 6 0 CCF $ 1 . & 6 Notary $ 5 , o t) Training/Education Fee $ -• (, () Technology Fee $ 1 . SZ Scanning $ Radon $ Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ 6 8 i 0 (Continued on opposite side) * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fee * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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 . a reinspection fee will be charged. Chc 10/14/03 Signature Owner or Age t The foregoing instrument was ackno `edged before this g 1 day of 1J , 20 C13 by 14(0131-Q tk , who is personally known to me or who has produced DA.1.0 • NOTAR Sign: Print: My Commission Expires: As identification an * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** State Certificate or Registration No. Certificate of Competency No. APPLICATION APPROVED BY: did take an oath. el Vargas missio #DD23I984 s: 13 (Certificate of Competency Holder) Signature • " l/l�,(.k.11 ) ` "-N-C `-t'& Contractor The foregoing instrument was acknow ed'e_d before me day of Lt.) or� , 20 0, by r t l Ur V l Q( J( who is personally kn. ' o me or who has produced tifica ' n . did take an oath. NOTARY PUB Sign: Print: My Commission E ********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * *`?: okittl*k3Y *2067 * * ** ' oFc Bonded Thru Atlantic Bonding Co , Inc _ 1 , •1l argas n #DD231984 Plans Examiner Engineer Zoning ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 1).4;..\i- 03 p-tt� MIAMI 1SHORES 9 7, 1 a � � DATE: \\ ''z\ o 5 • OWNER'S NAME: 'r v. 'D a. cX \ \ , . PHONE: Se S -"7 S ? - --) '3 6 O . ADDRESS: \24 °` Lp \•-• , ******* 4,******************** * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * ** * * ** 2-\ N ADDRESS OF SITE: \ '' ' E 0\ L S-\- CONTRACTOR & LICENSE p1' able) , L�, -.o-�\ ^ `c`(\ °, k COMPANY NAME: s L (i PHONE: cl a 5- C0 `1 -'7,--/;"-\°\ * O * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls c - - \ ° \ Fascia 'N a , 0 \'`).\" -\- Drip Cap/Drip Edge - W� Soffit W Q v , WV: - e , Roof Flower Bins — DG " �� A Shutters ---- N HS' o� Awnings V\P Chimney `.3 C - 1 4/2 and door jams `� � �' . 1 1 Garage-Deers -Railings ce Deceive etas A iek£- (sued- Stucco Banding a. \ (A-Ar\ W M1 Any other stucco features \(\)c.,. . 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. I authorize the above -named contractor, if applicable, to do the work stated. Furthermore , the paint colors will be as er the attached samples. Building Official Date Signature ** Owner * * * * * * ** * ** * * * * * * * * * ** *�* * of * * * ** * or Date * * * * ** * * * * * * * ** * * * * * * * * * * APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 • • Date 4-1 " Owner's Name Owner's Address Signature APPLICATION APPROVED BY: Miami Shores Village Paint Color Approval and Agreement A RiU 20 0 RID 1 LLYi - - I JL( tJ•E Qco City Mt P MI StiOR State �L- Owner or Agent Zip Phone # Cos )75e-8"0&2 • Job Address (where the work is being done) 1 2- e-( N • L q (v 57 City Miami Shores Village County Miami-I9 de Is Building Historically Designated YES NO V Contractor's Company Name (if applicable) (V) i C. ha. e.l h 0 ((mu n Phone it ************************************************ * * * * * * * * * * * * * * * * * * * ** * * * * * * * * ** All elements on the site must be listed and indicate the color Walls � - t Li y Fascia ()Cc v ct3 O 1-0 \A C+ , Drip Cap /drip Edge N a'JQ.O W 11lvi - Soffit iU av aJ O Roof Flower bins Shutters Awnings Chimney t-f C - i Li y -Deers and door jams 1�0. a3O wL11 +e° Garage doors Railings Fences '•— Zip 33(3$_ Decorative metal All brick (simulated or regular) Stucco banding Oa \/d O L0 I t e- Any other stucco features /avez 30 L,01, f - Accessory Buildings Other **************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work wi all applicable laws regulating construction and zoning. Date k ** Date 12/ h/0 y chc 6/1$/03 OP Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: BP2003 -1836 Printed: 4/2/2004 Applicant: ARTHUR CADILLA Owner: CADILLA ARTHUR JOB ADDRESS: 124 NE 96 ST Parcel # 1132060132690 Signed: (INSPECTOR) Building Permit Contractor HOFFMAN, MICHAEL STEPHEN Contractor's Address: 1235 MERIDIAN AVE #5 Local Phone: 305 - 673 -2244 Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 12 & 13 BLK 20 LOT SIZE 100.000 Fees: Description Amount FEE2004 -3406 Building Painting Fee $60.00 FEE2004 -3407 CCF $1.80 FEE2004 -3408 Notary Fee $5.00 FEE2004 -3409 Training and Education Fee $0.60 FEE2004 -3410 Technology Fee $1.50 Total Fees: $68.90 Total Fees: $68.90 Total Receipts: $68.90 Permit Status: APPROVED Permit Expiration: 10/2/2004 Construction Value: $3,000.00 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. Signed: (Contractor or Builder) BY: