BP-04-1244 (2)BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Owner's Name (Fee Simple
Owner's Address
City /2// J / State
Tenant/Lessee Name
$ Value of Work For this Permit j; a7
Total Fee Now Due $ ` .
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Electrical Plumbing Mechanical Roofing
/ ,s ass f1ESR T�,�/�,/� Phone # ( 7.f - 957
Job Address (where the work is being done) 4 e 94 �,
Cit Miami Shores Village County Miami -Dade Zip 33/3e
Is Building Historically Designated YES NO
Contractor's Company Name /j43 /. eIj//AEP/? D el42Z Phone # (70 - 17230
Contractor's Address 29/ Re /4., 4 L 8jQ ' L eif/ / , C � I/7 4 7
City AM/4 State Zip 3 3/3
Qualifier e M C Ejl /)E /'aE,
State Certificate or Registration No CCG-- (9-5 / Certificate of Competency No.
Architect/Engineer's Name (if applicable) e//45 /-/f/AJSEAJ Phone #
0 0
Permit No.
Master Permit No.
Zip 6 .3/.3 F
Phone # --
ECEOVED
SEP 1 b /0D4
- '2
Square Footage Of Work: /' 77e
Type of Work: ❑Addition ❑Alteration EtTew [( Repair/Replace ❑ Demolition
Describe Work: (' �J c t'Ees' (/4/ PLU41 doz_ ) �D,f /HL Lve; ��/-'� 4-4. , Gi,1��% f
( 2 ) 74)49 (& t'/S/c.'U ./..e)�a{' s 7e7z: (/v G4- i4'4/l, //Z pi,e) Celizyr -D
5y '/8 9IJ "C //ti1L 1/97E ®I/ - ,e / F6e,E - A c)./
** * * * * * * * * * * * * ******* * * * * * ** F ees * *** * * * * * * * * * * * ** * * * * ** * * * * * ** .ST S' /D &i .
Submittal Fee $ Permit Fee $ /50 CCF $ 3, CO/CC
Notary $ Training/Education Fee $ 1 r _• Technology Fee $ 30 75
Scanning $ Radon $ Zonin Bond $ ---- L
Code Enforcement $ Structural Plan Review. $ =t>U'
Opi4 50 (q552
Bonding Company's Name (if applicable),
P t
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 o such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Chc 05/13/03
Signature
Contractor
The foregoing instrument was ac .. u owledged before me this eo The foregoing instrument was acknowledged before me this 4'
day of � 200P, by 64,4 I Al/4 0 A , day of .57,444.— , 20 6 , by 4 (4. , 66 7 /X,...4".1
who is personally known to me or who has produced ten f on t / who is personally known to me or who has produced
/ r v► As identification and who did take an oath. e..1 1,7e /7
NOTARY PUBLIC: arir
�` I , 7 NANCY GONZALEZ i' OTARY PUBLIC: J " > MY COMMISSION # DD 271683
�ilY COMMISSION # DD 271663 PIKES: F�ruaq+ 15, 2006
S . a 7 •• , s x r-` - `= i „., „, 4 14: Sign: y; y Tfw Notary PubOCUnderwrites
j� �+ �, . Bonded Thu Notary Public ups
Print: /"Pi et q �a i e Print: 4 /6/„? e_ • A.
My Commission Expires:2 /j5o
APPLICATION APPROVED BY:
0.)
My Commission Expires: �s /
, , , * * * * * * * *i *, **it * * * * , sir * ** * * *it* * *, * * * * * ***** * ** ** *it * *le** r, rat le* * * * ** * * ** * * * *, * * it* * * it* it* * ic ** * * * * *** *it
* * * * * * * * * * * * * * *** *: ************************* *** * * * * * * * ** * * * * *** * ** ** ** * * * **** * * * *** * * * * * * *** * * *** **** * *** **
c 4— i' P ns Examiner
- ---- /;�
SERZAZOIligineer
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 9/27/2004
Applicant:
Owner:
JOB ADDRESS: 602 NE 96
Contractor CHARLES CULPEPPER
Local Phone: 305 - 759 -8255
Parcel # 1132060141410
Signed:
(INSPECTOR)
Building Permit
Permit Number: BP2004 -1244
ST
Contractor's Address: 801 brickell bay dr
Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 1 TO 10 INC BLK 61 LOT SIZE
Page 1 of 1
Fees: Description Amount
FEE2004 -9584 Building Fee $150.00 Total Fees: $472.75
FEE2004 -9585 CCF $3.00
FEE2004 - 9586 Training and Education Fee $1.00 Total Receipts: $0.00
FEE2004 -9587 Technology Fee $3.75
FEE2004 -9588 Scanning Fee $15.00
FEE2004 -9589 Builders Bond $300.00 �� /
Total Fees: $472.75
Permit Status: APPROVED Permit Expiration: 3/13/2005 Construction Value: $5,000.00
Work: AWNING
OCT 1 S ENTD
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:
NOTE: NOT TO SCALE Agr lsy.46
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MIAMI SHORES PRESBYTERIAN CHURCH OPERATING ACCOUNT 14352
a9/14/
FG
00 43vo
Se
aYr
A TJti1 jVqAYARZ AUgiAi
This is fo certify that the materials described on the reverse side hereof have been flame -
retardant treated (or are inherently nonflammable).
ADDRESS 2003 Corporate Drive
STATE FL 33426
FOR
CITY
3 04 08:08a
(a)
(LCertittcatc ot! jftame 3aeitantc
REGISTERED
FABRIC
NUMBER
T q
F -31.02
I.I.S
Boynton Beach
ISSUED BY
DURACOTE CORPORATION
350 North Diamond Street
RAVENNA, OHIO 44266
330/296-9600
Certification is hereby made that: (Check "a" or
The articles described on the reverse side of this Certificate have been treated with a flame - retardant
chemical approved and registered by the State Fire Marshal and that the application of said
chemical was done in conformance with the laws of the State of California and the Rules and
Regulations of the State Fire Marshal.
Name of chemical used Chem. Reg. No
M.ethod of application
(b) The articles described on the reverse side hereof are made from a flame- resistant fabric or material
registered and approved by the State Fire Marshal for such use.
The Flame Retardant Process Used WILL NOT
Ken Par shall By
Atcme of Production Superintendent
u .
AV t 1.151 M! tr1�U1.�L. L
fP Lf
,:b„
Mike Health
�
r7t1
!1� 1
Date manufactured
9 -8 -03
e Removed By Washing
RAC • CORP RATION
Quality Manager """.
11 ig 11t1)4TATATJ:T7� ..
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. S,P 4.2 '`f
STATE OF FLORIDA:
COUNTY OF DADE:
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address: 10/I�
Amount of bond
6. Lender's name and address:
TAX FOLIO NO. ZD 01
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real props trd $� Yc ith
L
Chapter 713, Florida Statutes. the following information is provided in this Notice of Commenceme . ° r r;
1. Legal description of property and street. address: G.1';? /U • E • �7 5 E7' M,,Mf/ - /c & t .33
SEE 14774 61/41 &cT
£ c'oLl S' CUE(' V� 174/6 1L'
2. Description of improvement: if-do �"' �' 4
(2) �o(z) /U /.S46.t Acne .sreUc' ' S I - e ,e740 cE�c•9 - zT'
3. Owner(s) name and address: A' / .SrATA5 ' - 5 217 / 9 & I C #L'4
6 o.2 4 `i‘ WET /hirivoil 5.7-444:5, pA • 3.3(3g
Interest in property: ;! _/6'7/1-1.
Name and address of fee simple titleholder:
4. Contractor's name and address: C W4 ' ea/°w . G ` 6. (25y3/)
few J #94- swIeS, ;4/ Beee�U !3 f / %e6-, //T 7 /004,,m. 33'
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address: jLPr A AM/V / / 7 ' e - 4/0/A)
'e°' 4'. /a/ al
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b). Florida Statutes.
Name and address: E.1 i7r i.e4 -Lk j-ladA , C t e a- of 5e5sttiO
3
e
S. Expiration date of this Notice of Commencement: (the expiration date Is 1 year from the date of recording unless a
dllerent date Is mod) O 6- loo f
/_.
Signature of • er
Print Owner's Name t
Sworn to and subscribed before me this �� day of Gdo ,,,, 20C) C'( .
Notary Public
Da dam F P0
Prepared byai3, Age/I)