PAINTName
Address
Company
Phone #
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date \l IA' Tim
Type Insp'n Q
Permit No. eD PO 3- \ O I
12 5 � E ggsT
305 - - I "7 - 7st
For Inspector:69 t 1O Name & Date
Approved
Correction
Re- Insp'n Fee ❑
PERMIT APPLICATION FOR MIAMI SHORES VILL GE
• 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax 305$ 972 ) 2003
,i ��U . Sht��pS ` -1
)ate'�W�e 24 G�O:JobAddress i� �I,E. x - Tax Folio
Legal Description Historically Designated: Yes No '
Owner /Lessee/Tenet y C o AG 4- ?)P X
�', ■ i rt . f . III < ( \(l S - , � C e l 13o$
t
Owner's Address q J • • �fA _ S�)t�f p 5 Phone �J +5 - 1 � - a / 8 b3- S6
Contracting Co.,) Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING
WORK DESCRIPTION:('
• d
Square Ft. Estimated Cost (value)
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 ANY 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 all disciplines.
OWNERS 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.
•
ignature of owner and/or Condo resident
My Commission Expires
FEES: PERMIT 6 O
'9 _ s k- ■✓\G T5 vk- 5 at. O Inc, use
Angela M Becker
• ` : My Comtnlaelon 130150048
dr Expires November 15, 2008
Date
Master Permit # 132cni3 1 O 3 r
ignature of Contractor or Owner Builder Date
A
Notary as to Contractor or Owner Builder Date
My Commission Expires
RADON C.C.F ■ 60 NOTARY S. 6 BOND
APPROVED:
�-�� (b �� g JUL — 1 2003
Zoning
ildin Electrical
Mechanical Plumbing Structural Engineer
P;Itd 0 Lt icxl 30 1* I ICS
TOTAL DUE 6S f7 0
Torecl s. o-
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE:w� e Z Z� 0 3
OWNER'S NAME: r, Aort'iala .� o -� - - (-\ PHONE: , j - s(o
ADDRESS: + 2\t I N\ F.. 9,`1- .
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: 1211 NI
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site rust be listed and indicate the color to be painted.
Walls
Fascia
Drip Cap/Drip Edge WPr
Soffit
Roof
Flower Flower Bins i3 - )1 r Zte1A- CCL 1� �u�►+'� �,q
Shutters CFA 2rI0 N(c1✓— C y 111 d - s �pN wi z- r �s e Ito
Awnings Ni /,4
Chimney WA'
Doors and door jams o - o\ca/..._
Garage Doors r 1�o —
Railings f4A-
Fences i d ' sr
re
L
APPROVED:
.0/4‘.../.
Buil•ing Offi
- c.c -21 -
Date
Decorative Metal iD9-'- c2 to lc - Cr I
All brick (simulated or regular) NSA
Stucco Banding rf/Y
Any other stucco features i Jfr
Accessory Buildings //1-
Other ,..Jf K
Alom
1 Body: Canoe ECC -13 -1`
DK.) •.a- 14 - :2`'
Li-10-01
Cordovan
C40 -52
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
giO3
Signature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
/'ill- 1=06
- 1
t\-bm DePo r
�i
\ 2
4/23/01
.i C --2I 2
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2
4
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2003 -1039
Printed: 6/30/2003 Page 1 of 1
Applicant:
Owner: HENDERSON REX
JOB ADDRESS: 1218 NE 98 ST
Contractor
Local Phone:
Parcel 0 1132050090350
Sig
Building Permit
Contractor's Address:
Legal Description: EARLETON SHORES PB 43 - 80 LOT 9 BLK 3 LOT SIZE 75.000 X 109
Fees: Description Amount
FEE2003 -3971 Building Permit Application Fee $60.00
FEE2003-3972 Notary Fee $5.00
FEE2003 -3973 CCF $0.60
Total Fees: $86.80
d Permit Status: APPROVED Permit Expiration: 12/22/2003 Construction Value: $300.00
Work: PAINTING EXTERIOR OF HOUSE
Total s: $85. �1
Total Rec fts: ` �
35. C
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.
ontractor or Builder) BY:
r
Memo
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ODas / Electric ['Credit Card
EITelepholTaxes
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OCIothIng
Eiragrzrzelzpl
a_rvki, .S\(1,0 S
( .L.
...Here's Haw:
• Cany balance forward
• Check type of expense
• Add details on memo line
• Retain duplicates In Deluxe Check box
penses...
['Entertainment 6 Travel DO NOT USE
OMedical / Dental
['Dependent Care
Savings & Investment
7r
„a-
QO
FOR REORDERING
•
BAL.
FORD
THIS
PAYMENT
CE
OTHER
BAL.
FORD
TAX DEDUCTIBLE ITEM
7'
(DEs. ( L)
NOT NEGOTIABLE
DateUvl,o2Z5C3Job Address la-(% )U2. C a � Tax Folio,'/ / ® 1
Legal Description q
L.; r,e � -
Owner's Address
Contracting Co. Ol L 9nc t'
Qualifier SS# - •
State # Municipal i'f Co• ' 4k_
Architect /Engineer
Bonding Company ss
Mortgagor \ - -
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ?n' n
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
** * * * * * * * * *
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
192 /Ve q
Fire
Address
t A /1iw___/M C/` 26 Master
Address
Phone S �S - '6 3 3
Square Ft. Estimated Cost(value) 411 •Q0
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.
Sigh-dtu
Date: 1 95
tary as to
My Commission
Permit 0 05:5V
Owner- Builder
**
FEES: PERMITi ` ' RADON C.C.F. NOTARY 5- ' 0 V TOTAL DUE g • M
Other
Zoning Building � ' 1 Electrical
Mechanical Plumbing Engineering