PAINTMIAMI SHORE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Type Insp'n
Permit No_ O 3 JCILN
Name
Address 3 CD.8 ( •
Company
Phone # � /IS
For Inspector ) )1) 1 0� e & Date
Approved
Correction
Re- Insp'n Fee
Dad i a
Job Addres Tax Folio
PERMIT APPLICATION FOR MIAMI SHORES VILLA(BE C EIVEIC
1005b N.E. ?nd Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax 305 - �;,, 89 2003
Legal Description Historically Designated: Yes p No
Master Permit # I1 2003 - 1044
Owner /Lessee/Tenet/ /LU 13 - i4 AVAIn
Owner's Address O ? - r4
Square Ft. Estimated Cost (value)
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all wo
Phone 2 4 4
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 550.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING
' ELECTRICAL PLUMBING MECHANICAL ROOFING
WORK DESCRIPTION: I LST U V , \ ' C.=A A -
yC
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 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.
will be done in compliance with all applicable laws
regulating construction and zoning. Furthermore, I authorize the above named contractor to d
Signature of owner and/or Condo President
a
Date
Nota0°;as to Owner and/or Condo President Date N..+ as to Co tractor o • er
My C4rnmission Expires My Commission Expires • • M
or Exp+rea ro....:
FEES! PERMIT 4' O n RADON
APPROVED:
Zoning /I...e"
Mechanical
Building
I Q Qsh 3cco � I a y1u 3
C.C.F b 0 NOTAR • 0 O
pH 3 0 2003
BOND
Date
kt
ate
TOTAL DUE !"
Electrical •
Structural Engineer
'•
0Sd 3 _
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE - • �`—�
OWNER'S NAME: DI . : . : PHONES `{ 5--(-1-
ADDRESS )' Di t -.f. q 'ST
*********q***********************
C� r * * * * ** *
AD DRESS OF SITE: 0 S ' * * * * * * * * * * * * * * * * * * * *. * * * * * * * **
) 1
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls he .r..•.....a.e. - ► •
Fascia
Drip Cap/Drip Edge
Soffit
Roof
Flower Bins I..J4
Shutters k.J7A
Awnings IVJA
Chimney NiN
Doors and door jams VU H ire
Garage Doors \ f t. i i .
Railings PA-
Fences NA
Decorative Metal OA-
All brick (simulated or regular) kAv4
Stucco Banding
Any other stucco features r4
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
construc ' : • _ i ing. I authorize the above -named contractor, if applicable, to
ermore , the paint colors will be as per the attached
APPROVED:
Building Official
p4-
Date
e Signature of Contractor Date
********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
° `E-- hoPot ,lc;
r
4/23/01
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: (, /'33 I g
OWNER'S NAME: L u (4- )C PHONE:
ADDRESS: '30$ kJ
* * * * * * * * * * * * * * * * * * * * * * * * ** ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applic: •1
COMPANY NAME:
****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * **
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
(A// #j
1,
PHONE:
All Elements on the site must be listed and indicate the color to be painted.
Walls I /(-
Fascia'
Drip Cap/Drip Edge
Soffit
Roof
Flower Bins
Shutters
2B
0
r
2148-40
COLOR Ew 2148
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
samples.
Signature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
at 4 / 3 43
Building Off 'al Date 4/23/01
IA 4
CALL FOR FINAL INSPECTION
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date .— I — Q'R Job Address 3 t R N E q'q Sr Tax Folio 1 1 -3 ,2o6—o13 - 5590
Legal Description Historically Designated: Yes
Owner / Tenant ( Q #J � (6/) /YI rc .5 0 Ai ft Master Permit # v A
Owner's Address 5 F} 47/7C
Contracting Co. / N / w °r* Address
Qualifier SS#
State # Municipal # Competency #
Architect/Engineer Address
FEES: PERMIT
WORK DESCRIPTION
Square Ft. Estimated Cost (value) S .3 Q o o a
My Commission Expires:
RADON
C.C.F. '' NOTARY
Phone 3 aTj — r] S 6 O O SU
Bonding Company Address
B -1070 CLASSIC SAND
Mortgagor Address
Permit Type (circle one): BUILDIN 1 ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
PA /N r /-/f O s E cx r-Rr ;R
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.
etAa. Q a413-11 92 - '8 -9g
Signature of owner and/or Condo Presi Date Signature of Contractor or Owner- Builder Date
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date
My Commission Expires:
APPROVED:
Zoning g 4)1 � Buildin r - Electrical
Mechanical Plumbing Engineering