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PAINTPage 2 IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from.8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTEC1ED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE /.< 1. ..7-1-01....--L-4— 6- Signature of Owner P., P w e Signature of Contractor / Qualifier Lc ,t_ R t C. F�Lr s P rint Name �+ Print Name S o •/ . ,d subscribed before me this d day of PC6 A' Sworn to and subscribed before me this day of IF A► 1 I/ a Signa .1 e o ota v Pu T *- 'fate F1!rida Signature of Notary Public - State of Florida d ``‘e OF Personally known Type of Identification Produced: OFFlCI b tARV SEAL P RV PUg AyGEL A M BECKER ‘.1 r ,.; ( "(' CpMONsaO$ $Uy,BER * CC7B6697 ON EXPIRES icaio� 15,2002 _ Personally known OR, Produced Identification SEAL: PERMIT APPLICATION Type of Identification Produced: PROPERTY OWNER Name U L k a. , F44„ wJ C-t s Address (.. bt,, Z L Sr . ' 3 Iezex �y,LJ, A) Y (I Z t 2— Home Telephone eiD 440 04 pou,. I1k6T _ 6 Business Telephone (g 0 2 . 3 S_ 3 4 // y L 3 i Fax (3v, - J 02. SS .- J/ i TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other INSTRUCTIONS - The followin steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION N ., Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other n2' A/ f(0 Sr- Address Apt. Folio Number // '3 2-0 6, 0 / 3 0,f 30 '\ Description of Work Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property Value of Work $ /3 w' ` Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax �l r 4 At t S SM' ee S City RAI lac— State PERMIT APPLICATION Master Permit No. Subsidiary Permit No. by � _ 0 Q c�. ' r � 33,3P Zip / � 4J7 - 7 A erce€ 2. Dr 4i )S ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE, Service Repair QTY. A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent Pressure Vessel Oven Space Heater (kw) A/C Central 16 -20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon PLUMBING TYPE A/C Condensate QTY TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture ()Ty. '1'YPI' Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning , yf 2 / 3 /, Electrical Mechanical Plumbing Fire Public Works Structural Building Official `�- _ .1.- '2 -- D ■ Page 4 OFFICE USE ONLY CHECKLIST ® OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ 6C), co Metropolitan Dade County (C.C.F.) $ / a ° (sq.ft. = x/1000 x ¢.60) 00 (¢.005 / sq.ft.) (¢.0I /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com r L 11 Pay to the Order of BARBARA A. RAY 8235 S.W. 132ND STREET MIAMI, FL 33156 ' / ram Ban�merica Ia ACH RIF 063100277 A — For /f "' °�} q Vs 1 :0 3000047h:. DOLL9 SE, 2889Lev 6 I — Date ^ 1 4 0 1 $ to c . .L.d 6275 �I Dollars 8 Bank of America Advantage 63-4/630 FL 888 Yelurn p a mn•. m+�WF QCLa Ar An+i as L GUARDIAN& SAFETY YELLOW TSVE F 001110^21M-- The SunshineState BARBARA BE3R2_4GE11 t, RAY_____ , 101 , 15675111i,'"f- - 8235'! SW- af/2- F 5-05 I eigy:wwint V. • If -21 a80'-"661146-712-0 6 - • •••••,{ .,.404,-,_0-600 • • CLA •••1. SS: E SAFE DRIVER C, 3-0131-59.7 MIAMI SNORES VILLAGE Paint Colbr Approval and Agreement DATE: 2/ j/0 L OWNER'S NAME: (0, a « , F / s PHONE: /o 6,4- 4.4 AA 44 ADDRESS: .Lfi N 96 Sr 3 0 5 - - .2.3s- 3 9// ya3 1 ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: e 2 - - 9 nJ C g 6 5 r • CONTRACTOR & LICENSE (if applicable) Pcrra /v Qu,ec.. COMPANY NAME: oc N3)ec- Prz2I' /2r% PHONE: o3v1 - -2-j7 - 7i6 S gam, * �r * ** * ** * * * * * * * * * * * * * * * * * * * * ***** * * * n* * s7 *l * * *' * * 5 * * *+* * * * * * * * * * ** * * ** All Elements on the site must be listed and indicate the color to be painted. Walls `�,r,/ GY!.// Fascia X41 re Drip Cap/Drip Edge Soffit 4-4/-1 Roof Flower Bins ►va,��. Shutters wkA - e. Awnings Chimney 1,1/11,01-e Doors and door jams Garage Doors Railings Fences Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features 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 per the attached sampled -c- 71d, 1.-- 41, S ignature of Owner D e Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION qi")/od, Building Off ial Date 4/23/01 1 • PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 4 1 1 / 1 4 4 11. Job Address 021 /1.1t5 ' k S T . Tax Folio Lc 1 C-4- I V / ' ► A t �.r. •� : S Legal Description � � , �''�i'storically Designated: Yes 3r . to pit lo Owner/Lessee / Tenant 11 - 4 -4• S Master Permit # Owner's Address G' 1 Q - 5 - �e(9.� K ' -K I �, N Phone ,D 9 - R 54 s , Contracting Co. t r • Address Qualifier State # Municipal # Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): WORK DESCRIPTION Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT '7 v. RADON APPROVED: Zoning Buildin Mechanical SS# Competency # Ins. Co. Address Address Address ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Square Ft. Estimated Cost (value) 17 di "7d" . o� 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. Signs of owner wel President Dater Signature of Contractor orner- Builder Notary as to Contractor or Owner- Builder My Commissio Ev fires p.9Y P0 OFFICIAL NOTARY SEAL 0 r G SCOTT W DAVIS 4( �; * COMMISSION NUMBER N : Q CC255237 7,, e's MY COMMISSION EXP. OF P.. JAN. 26 1997 S"6 fo C.C.F. NOTARY S TOTAL DUE �J Electrical 59'6 C e - Phone 757 - k ) 3 No Date Plumbing Engineering JEANNE BAKER, INC., REALTOR 12677 SOUTH DIXIE HIGHWAY MIAMI, FLORIDA 33156 -5931 PHONE: 233 -7990 STANDARD MANAGEMENT AGREEMENT RESIDENTIAL PROPERTY This Agreement entered into th between Ulric H. Franci of 19 hereinafter designated as the OWNER 9 corporation, hereinafter , and JEANNE BAKER ' designated as MANAGER. ' INC., REALTOR, a Florida WITNESSETH: That, for and in co nsideration of the covenants he and MANAGER agree with each other as follows: rein contained, OWNER 1. The N OWER hereby following W R he y employs the MANAGER for the sole rght described property, granting purpose of managing g F,in sole rig manage the Propert g tO such MANAGER all the described whomsoever, County's propert to of al managed including the OWNER. Count tO be so managed is ersons Y s current addressi ng system as: ADDRESS: 29 NE 96 Street, Miami Shores, FL 33138 Upon the ,terms hereinafter set beginning on the orth, for a period of 1 hereafter from mon h toay of 19�— -- years, Agreement b y givi month, until either ' and continuing the ed of n giving notice to the other party termi0ates this Y monthly period. Party thirty (30) days prior to 2. The OWNER grants to the MANAGER the following authority: a. Full management and to lease the property of said property with authority OWNER. and issue receipts therefor. with consent of b. To Pa scheduled on y all bills �� „ 6'6, estaty all bills Exhibit "A" attached hereto estate less than commissions, and all other bills, improvements real OWNER' /Zo. and repairs s or OWNER'S REPRESENTATIVE' except shall repairs). s a pproval shall first be obtained for other repairs or i mprovements. c. To serve vacate notices upon tenants and to the name of and R, a r rents, expense, take legal action to evict the ents, employing for these purposes a at an reputable d. To order leases and reW leases and renewals of existin enewals shall be executed b OWNER g leases; which new re presentative. Y the or OWNER'S e 1•4)g. • ) • I; e. CI) :i r •: CV'11"4,k4i' Olt •O■• . . CM, . .. • 41,1' • a 1: r r•!. ,• • (e': •. •p /i'..:yi r ! S ! •• L ' • dCZAX.S010102XXICLUCXXXXXXX MANAGER assumes no responsibility and OWNER holds MANAGER harmless from any actions resulting from MANAGER's inability to make payments on OWNER's behalf WV, if , , 4 9 4. 4! ! L • L kt ti • funds are not received from owner to cover authorized expenditures. f. The MANAGER is clothed with such other general authority and power as may be necessary or expedient to carry out the spirit and intent of this Agreement with respect to the management and operation of this property herein before described. 3. The MANAGER hereby agrees to perform faithfully and diligently the duties of a real estate managing agent. The MANAGER does not guarantee the payment of rentals by the tenants, but will make every reasonable effort to collect same when and as they become due. The MANAGER will send monthly statements showing rent received, payments made, and the cash balance at the end of the period. Such statements shall stand as approved unless exceptions are made thereto prior to the rendering of the next succeeding period's statements. MANAGER shall make semiannual property inspections. • o: av1•: •v . • j4Ji,• IF. 4 4 0 . 14'Ip • I::C, •.♦ . , •• r. •. . . 6, •. • . • . .1• rs: ' ! :•,b '• a • • 1 a •• .. fi r .. • P. r. . c •• y a�. ♦►?.1 , ,.+Y. . . . .t•. • . 1 •t. • .:t. �. • ! • MANAGER shall not be required to pay expenditures if OWNER's account does not have sufficient funds. . ,.. , • . +� t,. . • i• ' e. • '11 ' ir '• . •0,,•14, i.4n14\ ♦ .. r.. r. r; . . . • , . . rill. • , r , •,t, , 4 MiXdflilffdreMERMEEK 4. For its services, MANAGER shall receive: a. For managing: MANAGER shall charge a minimum of $70.00 per month which shall include MANAGER making semi — annual property inspections standard bookkeeping services of depositing monthly rent checks and and paying associated bills and a monthly statement showing income, expenses and the cash balance at the end of the month. b. For Additional Services Provided by MANAGER: The MANAGER shall charge OWNER based on time and materials or 10% of repairs and improvements performed by a third party. No additional services to be provided without permission of OWNER, except in emergency situation. 5. The OWNER shall indemnify and hold the MANAGER harmless of, from and against all loss, damage, suits and liabilities of every kind, nature and description arising out of or in any way connected with the property or the care, management, operation and maintenance thereof. 6. The OWNER shall maintain Premises Liability Insurance for bodily injury and property damage in an amount not less than $300,000.00 per occurrence. OWNER shall furnish MANAGER with evidence of insurance required herein, providing that the MANAGER shall be given at least 30 days' notice of cancellation of non - renewal. 7. OWNER hereby designates e� � .1 L- - 1 �5.�. as OWNER's local representative to act on behalf of the OWNER. MANAGER may rely on said Representative as having full authority to act on OWNER's behalf as granted in Exhibit "B ", Power of Attorney made a part hereof. WITNESS AS TO OWNER: X19 — q. -7f e Soc. Sec. 11 or Fed. I.D. 11 OWNER (SEAL) /30 - 6��t WITNESS AS TO MANAGER: Soc. Sec. # or Fed. I.D. 11 OWNER (SEAL) JEANNE BAKER INC., REALTOR BY: (SEAL) BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building tZ r rs t 1 MIAMI SHORES VILLAGE. FLORIDA ❑ DATE /? 195 ❑ PERMIT N9 4 Contractor's ❑ License No. d,'r, <.:.r ❑ Work to be performed under this Permit Architect Contractor or Builder ea . • Legal Lot Description Bl Address of Building 2 Subdi- vision Value of Project $ 2� t This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any 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 cr in the s tements or specifications and that he assumes responsibility for work done by his agents, servants or employees. • Signed. •••-• 11 Amount of 11 Permit $ +' INSPETTOR In consideration of the issuance to me of this permit I agree to perform the work covered, dreunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications su�imitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume rretiponsibil for all work done by either, myself, my agent, servant or employee. ! i CONTRACTOR OR, BUILDER BY AUTHORITY o Type Insp'n MIAMI SHORES VILLAGE BUILDINQ DEPARTMENT 305-74-2204 Building Inspection Request Date _ _Q ' et air` ( rc(�n y� f' - 137 6 o q1 e �� Permit No. Name /' Address c < / V r 9 �' Company 3 7r e H )4 - C° Phone # 303 7 q s ,- 2 0 5 - z --o'r— Inspection Date Re- Insp'n Fee ❑ Correction \Fr Miami Shores Village BUILDING PERMIT APPLICATIO FBC 2001 Tenant/Lessee Name Total Fee Now Due $ (continued on opposite side) Building De 10050 N.E.2nd Aven Contractor's Company Name - 5:4 7Z 4-41-7V-2 N c Contractor's Address . �"` l6' r, State Certificate or Registration No. - %(_ / City (4.m/ //ezczE "S State L Qualifier [,, I 2 `1 ,Q E'frv� C..t c Architect/Engineer's Name (if applicable) ` / . c / 77,A $ Value of Work For this Permit 50 6a -3 pt(cJ artment Phone # ? 1Y ' Type of Work: ❑Addition ❑Alteration ❑N w Describe Work: d . 3 _ — ; /Cm cv �'#- hores, Florida 33138 05) 756.8972 oe0 L ' ' 13-70 - Permit No. 1 ?" Master Permit No. T P2 ` ' - 6 j Permit Type (circle): uildin Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) kt .& 4.`wv" -1 E Phone # J�5 1 - .1 J ! 3 Owner's Address . F ✓ °VL ?6:., ' $ t Cit P'1 s 't'9r Gl State Zip "; / .-, Ar Phone # Job Address (where the work is being done) •x 9 A 9 6 C 'S 7 City Miami Shores Village County Miami -Dade Zip is Building Historically Designated YES NO t.,- r - .9-4 a i 3 Zip '7 / 3-4? Certificate of Competency No. Phone # Square Footage Of Work: / "Ci Repair/Replace ❑ Demolition j�j� ` * * * * * * * * * * * * * * * * * * * * * ** * * * * * ** Fees ) * * * * * * * * ** ** * * * * * * * * * * * * * * ** ** Submittal Fee $ ` Permit Fee $ 0 ' w CCF $ , & 0 CO /CC Notary $ V Training/Education Fee $ rtze Technology Fee $ { .60 Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ 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 constnlctiort 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 apps ed an reinspection fee will be charged. NOTAR Sign: Print: Chc 05/13/03 My Commission Expires: APPLICATION APPROVED BY: s identification and who did take an oath. ® 4 , < ISAr;LASSMAN c , MY COMMISSION# DID 066855 o EXPIRES: October 23, 2005 * * * * * * * ** * * * * * ** * * * * * ** *apt * *3E.48:PQWJaYc*at utt S wereig et*Ific ** ************************** *** *** ** * ***** ******** * *** * * * ** Signature Owner or Agent The f gom instrument was acknowledged before me this 7 The foregoin day of let' , 20 , by I (Qi ' of who is personally known to me or who has produced 4' p,@s l i Cu-`- Contractor strument was acknowledged before me this P- " , 20 , by 14 ada et 6'41140 who is personally known to me or who has produced or- NOTARY PUBL Sign: Print: P Z4 � LIJA CiLASSIVVAI es�� MY COMMISSION # DD 066855 9 �'p \OC EXPIRES: Octohe 1 3 1 00c * �c * * * * * * * * * * 1:F* : * ** :i- N* ARY F L Notary Servic * e 8 BoncOng Inc My Commission Exp * * * * * * * * * * * * * * * * * * * * ** ************** * * * * ** * * * * * *** * * ** * * * * * * * * * ** ** / 0,1 NOV 01 as identification and who did take an oath. Plans Examiner Engineer Zoning Miami Shores Village • Faint Color Approval and Agreement Date e n -1 7 "U I 1 - l0. e- te1 vi,er �N�t f -11. e�fif . , Phone# 3e5 ZfZ 2 Owner's Name � Owner's Address a ( Gy C- / r /r 6 ` S / Cit Hi a-' Siorr^ State - Zip 3 3 / 3 r Job Address (where the work is being done) 3 / City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO ✓ 3a5 3 ' 2 3 Z 5 applicable) 5 6� D 4- /'v' Phone # 3°5' 0 gr� ° ? 3 Contractor's Company Name (if app � ) ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to W W alls 4.11 c�gK -r i - 104/1 - 4 1 �.�!, I / e 416 0 ' 1 s� Fascia I 6 ati� Drip Cap /drip Edge 6 /114 )tint ` Soffit G,4-it? ---e) C a l o r" , ,. /V/4- ig li tS � Roof Flower bins N/� Shutters N /A- :/t � Y Awnings N/k Chimney 4 r Beef i y Pe-L-ni - /e614 Doors and door jams OA Garage doors N I A Railings N / Fences - Ai/ 4 Decorative metal 4 A J All brick (simulated or regular) 'U / 4 Stucco banding_ 4 C-- A-ffe'e-- eft 7 - lslz w(&4 Ze / Any other stucco features Signature APPLICATION APPROVED BY: Owner or Agent P& Z Official (/ ea A CAMEO AC -207 16' Street, Pompano Beach, FL. 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 cons ' ction and . s g. Rm COLOR E ' * ** Date /G -17- t / Date 7,71. r / /y` chc 6/18/03 Applicant: MADELEINE Owner: ROMANELLO JOB ADDRESS: 29 NE 96 Contractor SARABANDA INC. Local Phone: Parcel # 1132060130830 Signed: (INSPECTOR) Building Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2004 -1370 Printed: 11/2/2004 ROMANELLO MADELEINE ST Contractor's Address: 160 NE 99 STREET Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 BLK 6 LOT SIZE 100.000 Fees: Description Amount FEE2004 -10754 Building Painting Fee $60.00 FEE2004 -10755 CCF $0.60 FEE2004 -10756 Technology Fee $1.50 FEE2004 -10757 Training and Education Fee $0.20 Total Fees: $62.30 Total Fees: $62.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 4/16/2005 Construction Value: $500.00 Work: PAINT AS AGREED 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 Printed: 11/2/2004 Applicant: MADELEINE ROMANELLO Owner: ROMANELLO MADELEINE JOB ADDRESS: 29 NE 96 ST Contractor SARABANDA INC. Local Phone: Parcel # 1132060130830 Fees: Description Amount FEE2004 -10754 Building Painting Fee $60.00 FEE2004 -10755 CCF $0.60 FEE2004 -10756 Technology Fee $1.50 FEE2004 - 10757 Training and Education Fee $0.20 Total Fees: $62.30 Total Fees: $62.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 4/16/2005 Construction Value: $500.00 Work: PAINT AS AGREED Signed: (INSPECTOR) Building Permit Permit Number: BP2004 -1370 Contractor's Address: 160 NE 99 STREET Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOTS 15 & 16 BLK 6 LOT SIZE 100.000 In consideration of the issuance to me of this permit, 1 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 BUILDING DEPARTMENT 305- 795 -2204 5 Building Inspection Request 62 Date /2-(=:1 Type Insp'n Fr (ICI 1 E er %or AtieveAtocl. Permit No. aRD 4- Name 940nrr.netlo - Address � va 4 1 Gef, &— Company X1 kCdt _ Phone # Inspection Date 1Z7 Correction Re-Insp'n Fee ❑