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BP-05-283• FBC 2001 BUILDING PERMIT APPLICATION $ Value of Work For this Permit 2`Etc) Total Fee Now Due $ / / � i i c" ` c (Continued on opposite side ( Pp side) 10050 N.E.2nd A entit(r, c tL rlo dda 33138 Tel: (305) 795.2204 Fax: ( 305) 6. ; 972 Permit No. aster Permit No. e, ' =!T s'sE kid afietti, lac ot4L )• Permit Type (circle): Buillding Electrical Plumbing Mechanical Phone # ****************************Fees****************************** CCF $ 6i g® Technology Fee $ Submittal Fee $ � Permit Fee,$ /,070 Notary $ Training/Education Fee $ O r 60 Scanning $ Radon $ Zoning Code Enforcement $ Structural Plan Review. $ Roofing 3o.C Owner's Name (Fee Simple Titleholder? Owner's a�ddress e'}[ -- 1 4. e q6,7 k(t t i .?„ .; '' . • ,.0 City /(114i .411040 State 6 . Zip F3/38 Tenant/Lessee Name Phone # Job Address (where the work is being done) v 94i,174, City Miami Shores Village County Miami -Dade Zip 33/ Is Building Historically Designated YES NO ✓ Contractor's Company Name V' S� 041" ( P y ��Tts4i Phone # Contractor's Address 61/4) A r. 6 City A 5 (( State ri Zip 3 3 l3 e Qualifier b8 \ rjiD ,i . - rg State Certificate or Regishation No. 14 1r Certificate of Competency No. of {3 5©o2/ 4 Architect/Engineer's Name (if applicable) NI/Dr Phone # Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ['New ❑ Repair/Replace ❑ Demolition Describe Work: 3or' 76 - 7/‘ Bond $ CO /CC' Bonding Company's Name (if applicable) Bonding Company's Address City State s _ / 1 �� Zip Mortgage Lender's Name (if applicable) u r 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. \)1 41/ Signature (/ %61 -flI L) , L4. _ Si Owner or Agent The foregoing instrument was acknowledged before me this day of 4 . tr who is personally NOTARY P LIC: Sign: ''II ■ 3 , Print: a rctrc, 4. ° APPLICATION APPROVED BY: Chc 05/13/03 2001(, by WG �c own to me or who has As identification #id * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * ** oa I • � -ss • oN. =y • ' 2 •o S. • ndedtt•c4 ublicus 'gym • c"• . 7A , t''°°' My Commission Expires: s i I . t' tti ***************** * * * * ** * * * * * ** * * ** * * *** * * *** * * ** ) Contractor The foregoing instrument 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. NOTARY PUBLIC: Sign: Print: My Commission Expires: *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** n!� +22C 5 J Plans Examiner Engineer Zoning Miami Shores Vill • 'Paint Color Approval and Agreement Date J. 4.05 1(AG 4*rtivik 1 jj , COMA. —%- ( 5rPu 4 4) Owner's Name M . Pizettreati Phone if 3,5v 9 ( Owner's Address City at kilt s if � S State e Zip 33( 3te Job Address (where the work is being done) ( 14.6: q((o No4 k(' ., p City Miami Shores Village County Miami -Dade Zip 33134 Is Building Historically Designated YES NO . '✓ Contractor's Company tor's Com Name (if applicable) ' 01-r. qi.k,:t to Phone # 3 `' ` — I 1 CI( Y ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Walls Fascia Drip Cap /drip Edge Soffit Roof Flower bins Shutters Awnings Chimney Doors and door jams Garage doors Railings Fences Decorative metal MI 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. Signature APPLICATION APPROVED BY: Owner or Agent P& Z Official Attach Color Samples With Numbers Date Date J 6 chc 6/18/03 O A Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/16/2005 Applicant: Owner: JOB ADDRESS: 602 NE 96 Parcel # 1132060141410 Signed: (INSPECTOR) Building Permit Permit Number: BP2005 -283 ST Contractor VISCOUNT PAINTING & DECORATING Contractor's Address: 640 GRAND CONCOURSE Local Phone: 305 - 751 -7164 Page 1 of 1 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 1 TO 10 INC BLK 61 LOT SIZE Fees: Description Amount FEE2005 -3397 Building Fee $100.00 FEE2005 -3398 Training and Education Fee $0.60 FEE2005 -3399 CCF $1.80 FEE2005 -3400 Notary Fee $5.00 FEE2005 -3401 Technology Fee $2.50 FEE2005 -3402 Scanning Fee $6.00 Total Fees: $115.90 Total Fees: $115.90 Total Receipts: $115.90 Permit Status: APPROVED Permit Expiration: 8/27/2005 Construction Value: $2,480.00 Work: PAINTING CHURCH STEEPLE ONLY 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: 3/16/2005 Applicant: Owner: JOB ADDRESS: 602 NE 96 Parcel # 1132060141410 Signed: (INSPECTOR) Building Permit Permit Number: BP2005 -283 ST Page 1 of 1 Contractor VISCOUNT PAINTING & DECORATING Contractor's Address: 640 GRAND CONCOURSE Local Phone: 305- 751 -7164 Legal Description: MIAMI SHORES SEC 2 PB 10 - 37 LOTS 1 TO 10 INC BLK 61 LOT SIZE Fees: Description Amount FEE2005 -3397 Building Fee $100.00 FEE2005 -3398 Training and Education Fee $0.60 FEE2005 -3399 CCF $1.80 FEE2005 -3400 Notary Fee $5.00 FEE2005 -3401 Technology Fee $2.50 FEE2005 -3402 Scanning Fee $6.00 Total Fees: $115.90 Total Fees: $115.90 Total Receipts: $115.90 Permit Status: APPROVED Permit Expiration: 8/27/2005 Construction Value: $2,480.00 Work: PAINTING CHURCH STEEPLE ONLY 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: 3/16/2005 Applicant: Owner: JOB ADDRESS: 602 NE 96 Parcel # 1132060141410 Signed: (INSPECTOR) Building Permit Permit Number: BP2005 -283 ST Page 1 of 1 Contractor VISCOUNT PAINTING & DECORATING Contractor's Address: 640 GRAND CONCOURSE Local Phone: 305 - 751 - 7164 Legal Description: MIAMI SHORES SEC 2 PB 10-37 LOTS 1 TO 10 INC BLK 61 LOT SIZE Fees: Description Amount FEE2005 -3397 Building Fee $1 00.00 FEE2005 -3398 Training and Education Fee $0.60 FEE2005 -3399 CCF $1.80 FEE2005 -3400 Notary Fee $5.00 FEE2005 -3401 Technology Fee $2.50 FEE2005 -3402 Scanning Fee $6.00 Total Fees: $115.90 Total Fees: $115.90 Total Receipts: $115.90 Permit Status: APPROVED Permit Expiration: 8/27/2005 Construction Value: $2,480.00 Work: PAINTING CHURCH STEEPLE ONLY 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: