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858 NE 97 St (12)
MIAMI SHORES VILLAGE BUILDI J) DEPARTMENT 305 -7tk,- "'04 Bui ding Inspectiu. Request Date ( le Type Insp'n Y ( I n ,4- Permit No. f " — 04 15 Name C t �C . (� c Address �� g q? u Company OWA - ) Phone # � Inspection Date Correction it 11 . Re- Insp'n Fee ❑ Bonding Company's Name (if applicable) Bonding Company's Address City State 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. Signature sz4 Owner or Agent The foregoin instrument was acknowledged before me this c 2 - 7 d a y of 0 C ,20O , by Avvwf, fi &V(1S , who is personally nown to me or who has produced I As identification and who did take an oath. NOTARY Sign: Print: My Commission Expires: APPLICATION APPROVED BY. Chc 12/15/03 Zip r y IVilab ©D u p s lees: Jui 13, 2007 v'- ...•o� ono ' (? ;` ' Atlantic Bonding Co . Inc State Certificate or Registration No. Certificate of Competency No. Signature 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: 984 Sign: Print: My Commission Expires: (Certificate of Competency Holder) OCT 2 9 2004 .. /DA 0 y Plans Examiner Engineer Zoning v � Permit Type (circle): 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 11 -#-- as3 V ■J 3o5 )Ct5 - 2Z to BUILDING NIECEIMM Permit No. 6° U- i ( 1 LS PERMIT APPLICATIO QCV 2 7 Ka Master Permit No. FBC 2001 Electrical Plumbing Tenant/Lessee Name Phone # Mechanical Roofing Owner's Name (Fee Simple Titleholder) 6' le n 1 rnce Phone # 3OS '92 Lv ie, Owner's Address etc Pl t✓ G101 Si City Mictiril itiO9e.S State ring-ed. Zip c '3/3 r Job Address (where the work is being done) $ ? ,VE q0 11/1 s e City Miami Shores Village County Miami -Dade Zip 3 313 V Is Building Historically Designated YES NO Contractor's Company Name Ow Phone # Contractor's Address City State Zip Qualifier Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit )( •OC, Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ENew ❑ Repair/Replace ❑ Demolition Describe Work: I4t.€4:17,J/ h 1�7,e�LQ.� * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ (00 • OC Notary $ S - 00 Training/Education Fee $ Scanning $ Radon $ Zoning Code Enforcement $ Structural Plan Review. $ CCF $ • 60 CO /CC Technology Fee $ l - 50 Bond $ Miami Shores Village - Paint Color Approval and Agreement I o/ A0 /04, /l Owner's Name /4 fYl2P� °� �� / Ai) klaki I5 Owner's Address + , $` , � � , /6 1'7 $'7 2 Q r City ml OAl / $kV , iS State W Zip 32/3 fg Date Job Address (where the work is being done) > f /✓C 9' 17 ) .Thep City Miami Shores Village Is Building Historically Designated YES NO Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** be listed and indicate the color to be painted All elements on the site must Walls ✓ Se/1D59t/77 Fascia ye/ o i,i..4 ie_., Drip Cap /drip Edge V (•e€ 0 CCU 1C ' • Soffit IQ (�� OA A" Roof �J Signature . dis7+—ei 9 M -4. Owner or Agent APPLICATION APPROVED BY: Phone # 305 (P Li g J County Miami -Dade Zip j'313 P Flower bins Shutters Awnings Chimney Doors and door jams Garage doors Railings Fences Decorative metal All brick (simulated or regular) Stucco banding Any other stucco features Accessory Buildings Other ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Attach Color Samples With Numbers cnK;C27C:: PP - �9 L VIEJO WHITE P -12L+ Date /d /a - /O/ Date /4��v/ chc 6/1$/03 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/2/2004 Applicant: AIMEE Owner: HARRIS JOB ADDRESS: 858 Contractor Local Phone: Parcel # 1132060142720 NE 97 Signed: (INSPECTOR) Building Permit Permit Number: BP2004 -1415 HARRIS AIMEE ST Contractor's Address: Legal Description: MIAMI SHORES SEC 3 PB 10 - 37 W1/2 LOT 7 - ALL LOT 8 BLK 74 & E1/2 LOT 9 LOT Fees: FEE2004 -10768 FEE2004 -10769 FEE2004 -10770 FEE2004 -10771 FEE2004 -10772 FEE2004 -10773 Description Building Painting Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $60.00 $0.60 $5.00 $0.20 $1.50 $67.30 Total Fees: $67.30 Total Receipts: $67.30 Permit Status: APPROVED Permit Expiration: 4/25/2005 Construction Value: $500.00 Work: PAINT AS AGREED Page 1 of 1 , 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: AIMEE Owner: HARRIS JOB ADDRESS: 858 Contractor Local Phone: Parcel # 1132060142720 NE 97 Building Permit Permit Number: BP2004 -1415 HARRIS AIMEE ST Contractor's Address: Legal Description: MIAMI SHORES SEC 3 PB 10 -37 W1/2 LOT 7 -ALL LOT 8 BLK 74 & E1/2 LOT 9 LOT Fees: FEE2004 -10768 FEE2004 -10769 FEE2004 -10770 FEE2004 -10771 FEE2004 -10772 FEE2004 -10773 Description Building Painting Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $60.00 $0.60 $5.00 $0.20 $1.50 $67.30 Total Fees: $67.30 Total Receipts: $67.30 Permit Status: APPROVED Permit Expiration: 4/25/2005 Construction Value: $500.00 Work: PAINT AS AGREED Signed: (INSPECTOR) E 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: Page 1 of 1