916 NE 96 StBUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle . Building ) Electrical Plumbing Mechaniical Roofing
Owner's Name (Fee Simple Titleholder) ,2 /(40 4 ?-( 4 ' / kV Phone # 3i S —257-- 369' 3
Owner's Address 9 Nt�c , 7!�
2L
///
City // //n / ` State F'1 Zip 35/ g '!
Phone #
Tenant/Lessee Name
Job Address (where the work is being done) Q � ' g
City Miami Shores Village
Is Building Historically Designated YES
Contractor's Company Name
Contractor's Address
Architect/Engineer's Name (if applicable)
$ Value of Work For this Perming (g 7e. 'eV
Type of Work:
Describe Work:
['Addition EAlteration ,New
1/14 Peilh''n ��� ,
Total Fee Now Due $ VJ U , ( 0
(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
County Miami-Dade Zip
RECEOVED
AU6 1 6 2004
Permit No. 6PU Li - i' V C 1
Master Permit No.
NO X toy
Phone # 3 "/
City /Al ilit'/.I ' � � L� Zip
Qualifier
Registration No
State Certificate or Re
g 7703aYa / 005/33 Certificate of Competency No.
Phone #
Square Footage Of Work:
❑ Repair/Replace
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * *k
❑ Demolition
Submittal Fee 5 Permit Fee $ (.0 0 ' 00 CCF $ 1 ' E v c c o / /
Notary $ 5 . C0 Training/Education Fee $ , 4 0 Technology Fee $ ) - ,JV
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Nine (if applicable)
Bonding Company's Ac i`ess
T ^
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Adckess
City State Zip
Application is hereby de to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this j i ction. 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 AFFIDA \T: 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 O ER: YOUR FAILURE TO RECORD A NOTICE; OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE I+ R 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 $2500, the applicant must
promise in good faith /hat a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subftct to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be *proved and a reinspection fee will be charged.
Signature
Owner or Age p�
The fore rng instntr►tnt was ackd'C hedged befor me this
day of , 2� by
who is person ly known to me or who bas produced T
Val' ;� a
te i (fit ,• t i %id take an oath.
13, 2CO`t
NOTARY
Sign:
Print:
My Commission Expi 'es:
*****************$*************** * * * * * * * * * * * * * * * * * * * * * * * * * * * *
APPLICATION AP112.OVED BY:
Chc 05/13/03
Signature
Contractor
The foregoing instru ' ent was acknowledged before me this
ay of , 0_, by
who is personally known t me or who has produced
as identi cation and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
************************************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * **
�J $& 7 747
* * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * **
Plans miner
Engineer
Zoning
Date
Owner's Name
Owner's Address
City i Am(
Job Address (where the work is being done) 9 e v ' ` 9 57 .
City Miami Shores Village County Miami -Dade Zip ' 3 / 5
Is Building Historically Designated YES NO X
Contractor's Company Name (if applicable) Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Walls 0 C 4 iV "' E4t 1 n'O C — 5
Fascia 4 . ft 5,or 730c- /
Drip Cap /drip Edge
Soffit
Roof i/Z
Flower bins I - 2 go e
Shutters
Awnings
Chimney
Doors and door jams
Garage doors
Railings
Fences
Signature n f 4
APPLICATION APPROVED BY:
Miami Shores Village
~Faint Color Approval and Agreement
CSie State
b sr
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 info
applicable laws regulating construction and zoning.
A
or Agent
Zip
Phone #
,� c e e t' t'^ ? c r
* * * ** *#*********** * * * *t * * *4
a
tioruca curate and that all worts.
c am`(.
7SC� •` u
Sea Salt
78a3,2 u
Date
c - /6 —ey
Date / / y
chc 6/18/03
rith all
Miami Shores Village
10050 NE 2nd Avenue
Building Permit
Phone: 305 - 795 -2204 Permit Number: BP2004 -1109
Printed: 8/18/2004
Applicant: MICHAEL TAYLOR
Owner: TAYLOR MICHAEL
JOB ADDRESS: 916 NE 96 ST
Contractor
Local Phone:
Parcel # 1132060143020
Contractor's Address:
Legal Description: MIAMI SHORES SEC 3 PB 10 - 37 LOT 10 & W1/2 LOT 9 BLK 76 LOT SIZE 75.000
Fees: Description Amount
FEE2004 -8389 Building Painting Fee $60.00
FEE2004 -8390 CCF $1.20
FEE2004 -8391 Notary Fee $5.00
FEE2004 -8392 Training and Education Fee $0.40
FEE2004 -8393 Technology Fee $1.50
Total Fees: $68.10
Total Fees: $68.10
Total Receipts: $68.10
Permit Status: APPROVED Permit Expiration: 2/12/2005 Construction Value: $1,200.00
Work: PAINT
Page 1 of 1
no
Signed: (INSPECTOR)
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: