The URL can be used to link to this page

1269 NE 99 St (3)BUILDING PERMIT APPLICATION FBC 2001 $ Value of Work For this Permit 3 t0©0 Type of Work: Describe Work: Total Fee Now Due $ (Continued on opposite side) r,7o Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): , Roofing Name (Fee Simple Titleholder) t-1 n3\ �' 12. n UQ (T f Phone # 30 'It 02 ' CoT `'15 Owner's Address 1210q �e qq ST City 1.1grn1 Shoes State Zip 331,g Tenant/Lessee Name Phone # Building Electrical Plumbing Mechanical Contractor's Company Name NA t C'( 1ae, `s 1-6nye kin\i Contractor's Address 1 7 (, YE3C City I.\ipsyy11 State 1"L___ Qualifier t 2 QS Job Address (where the work is being done) City Miami Shores Village County Miami -L Is Building Historically Designated YES NO Architect/Engineer's Name (if applicable) * * * * * * * * * * * * * * * * * * * * * * * * * ** *F ee ** Submi tai ee $ Permit Fee $ Notary $s. 0 0 Training/Education Fee $ Scanning $ Radon $ Zonin Code Enforcement $ Structural Plan Review. $ Permit N PO { Master Permit No. Typelnsp'n Address Approved Correction Re- Insp'n Fee Company Phone # Inspection Date / a7 ; 14( MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Parr)) Permit No. 46p2 63Q. Name Ty `l./'rAf la(e)q N ggsl Bonding Company's Name (if applicable) 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 occu s seven (7) da a Jer the building permit is issued. In the absence of such posted notice, the inspection will not be approved a d a einspectio fee will be charged. Signatur Chc 12/15/03 Owner or Agent contractor The foregoing instrument was a owledged , s . r- me this ! The foregoing instrument was acknofvledged be d of L.r 200 lib ° � �r; f► '' P� .mi day f , 200__Y, who is personall known to me or who has produced who is personally known to me or who has produced d who did take an oath. • , ,n■ My Commission E Tres Y � My Commissicln"Expires, (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Mph 1 3 2004 APPLICATION APPROVED BY: «identification and who did take an oath. NOTARY S .-).24))/ Plans Examiner Engineer Zoning MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: 5 ` i0 IOi-I OWNER'S NAME: ADDRESS: 12 (.a *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: 2.(2k tJ gq, ST CONTRACTOR & LICENSE (if applicable) COMPANY NAME: 1t in 9. [kM Q. PHONE: 305 vi Er I812eS *********************m**************************************** Drip Cap/Drip Edge Soffit Roof Flower Bins kt G Li r1 Shutters Awnings Chimney Doors and door jams tie.. 15 S Garage Doors VIrC.. t4 Railings Fences Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features Accessory Buildings Other Signatur- of Owner * * * * * * * * * * * * * * * * ** APPROVED: Building Offi PHONE: ao5'I(Q2-cam All Elements on the site must be listed and indicate the color to be painted. Walls 1 b l2( ekamaCUAL -N . F(l - Fascia 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 amples. 10 0L _ Date Signature of Contractor Date *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 247 4 Date 4/23/01 Miami Shores Village 10050 NE 2nd Avenue Building Permit Phone: 305- 795 -2204 Permit Number: BP2004 -639 Printed:5 /14/2004 Page 1 of 1 Applicant: ANN MARIE INDORF Owner: INDORF ANN MARIE JOB ADDRESS: 1269 NE 99 ST Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET Local Phone: 305 - 895 - 1368 Parcel # 1132050090110 Legal Description: EARLETON SHORES PB 43 -80 E1/2 LOT 14 & LOT 15 LESS E25FT Fees: Description Amount FEE2004 -4884 Building Painting Fee $60.00 FEE2004 -4885 CCF $1.80 FEE2004 -4886 Notary Fee $5.00 FEE2004 -4887 Training and Education Fee $0.60 FEE2004 -4888 Technology Fee $1.50 Total Fees: $68.90 Permit Status: APPROVED Permit Expiration: 11/9/2004 Construction Value: $3,000.00 Work: EXTERIOR PAINTING Signed: (INSPECTOR) Total Fees: $68.90 Total Receipts: $68.90 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: