600 NE 98 St (14)3/B
.ICATION FOR MUNICIPALITIES OF DADE COUNTY
s`e � (OWNER TO RETAIN COPY)
f . QZ 1 0 J 7/4 •7 .Maid! ,9 /!Qi
Owner / Lessee / Tenant //Re /R5 61/44,0W5
Owner's Address (,. A LE %Q S%
Contracting Co. R05,tl3T N Co
Qualifier / ?oB i f .0 a i 97
StateO /4
Architect /Engineer
Bonding Company
Mortgagor
1482
Signature of Owner and /or Condo
Date:
!dress OO /()i' 5/q s7 -
/ Tax Folio // 5,1_06//7 /ego /
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION P , Ess / E c_akv - f'. //(JT 7 C )i/l7Z - 7c co z_o R
SAM PLE - fe9 /Air 5044E i v7 OR i o6P?s
Square Ft. Estimated Cost
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.
President
Not(ry to Owner and/or on o President
My Commission Expires: /0 * A
PERMIT FEE: APPROVED:
Zoning
Mechanical
Competency 1/4.;
Address
Address
Address
Fire
Building
Plumbing
Address
Master Permit #
Phone
ss #0 1 - ;Z9 - 2Cz5O Phone
737 .593
1/70/W $,5C CJ 1D /V /4/9
gy3 - 6 994 _
Ins. Co. (13RE/1 /l ,EpU ?L /G
e ,d,t1 -
Signature of Contractor or Owner- Builder
Date:
Notary ass to Contractor o Oyn - Builder
M Commission Expires: 'V///
* *
,�`��1�
Electrical
Engineering
*
CONTRACTOR
Name et ce l 1 ......1a4W V71--r
Address / 60 giu 91
/lfQi /,. R • 33/3
Name e on. _ 4 l
t
ii
Licensee No. ®/ 7 ,3/
Repair
7031
Add /
C (76 (l l 3t/
/) , /@ '
S
33/x(
Demolish
Telephone g fl/
/C l
Fax F
,e7 1r c 7
Qualifier Name
1
PROPERTY OWNER
Name et ce l 1 ......1a4W V71--r
Address / 60 giu 91
/lfQi /,. R • 33/3
Enclosure
Home Telephone C305 7
593
Business Telephon ( f) 717
Repair
7031
Fax
Demolish
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
1 11
1111d'1/1111 hail i C'. II 11
PERMIT APPLICATION
4 • i rr °r °ails iippi. i
IMSTRUCTIONS - The following steps must be taken to obtain a pgrmit from the Miami Sh Village:
Step 1.
Master Permit No.
Subsidiary Permit No. 8 P' (-900a • (D6! L
Complete the attached perrfiit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a More accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
1:
111
Job Address:
4r® gr S'fi
Address Apt.
rk ,04 j'Lc
City
State
33/3e
Zip
Folio Number Description of Work CAI" j 'C"Yd( />
Lot Block
Subdivision PB PG Zoning
Current Use of Property Square Feet Units Floors
Proposed Use of Property Value of Work ; 73 Bldg Value
Tax AssessedlAppraised Value
Flood Zone Base Floor Elev.
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Linear Feet
ENGINEER
Name
License No.
Address
Telephone
Fax
SECTION
BY
DAT
Zonin
o /
yhi va
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
,`
`)•"f c2�
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEEri
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ �o'
S; 0 O
REVIEWED AND PREPARED BY:
(sq.ft. = x/1000
x t.60)
(¢.005 /sq.ft.)
(0.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ 47 b o c
ISSUING OFFICIAL
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
PAY TO THE
ORDER OF
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 4/15/02
Applicant: CHARLES
Owner: SAMMONS
JOB ADDRESS: 600
Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET
Local Phone: 305 - 895 - 1368
Parcel # 1132060171840
Fees:
FEE2002 -1971
FEE2002 -1973
FEE2002 -2173
Permit Status: Approved Permit Expiration: 10/2/02
Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
If there is no permit package accessible on the job -site for inspectors to verify, there will be nby.lnspections. Re- inspection
tion.
COMPLETE HOME PAINTING
BY MICHAEL
1476 NE 130TH ST. PH. 305 - 895 -1368
NORTH MIAMI, FL 33161
w / .J
Washin n Mutual
Washington Mutual Bank, FA
North Mlam 1125th Street Financial Center 1728
900 NE. 125th Street 17300.7148 -7000
North Miami, FE 33161 24 hour customer Senmca
MEMO
NE 98
Total Fees:
1:26 7084 L3 11:13 3 L11148 3 5 L L111 311 3400
Legal Description: MIAMI SHORES SEC 4 AMD PB 15 -14 LOTS 11 & 12
Description
Building Permit Application Fee
Notary Fee
CCF
63- 8413/2670
831483
`L1
DATE
1 $ ‘if
OW :LARS IJ -an
Permit Number: BP2002-694
SAMMONS
CHARLES
ST
Amount
$60.00
$5.00
$1.80
$66.80
Construction Value:
: =3 400
j
BY:
BY:
8,475.00
�1 d
Page 1 of 1
Total Fees: $66.80
Total Receipts: $0.00
BLK 101 LOT SIZE
he equipment or device described in the application herefor in strict compliance with all
with any plans, drawings, statements or specifications that may have been submitted to
I not done in compliance with such ordinances or if the plans are changed without
;tor or builder named above assumes the responsibility for a thorough knowledge of the
tgs or in the statements or specifications and that he assumes responsibility for work done
i compliance with all ordinances and regulations pertaining thereto and in strict conformity
es Village. In accepting this permit I assume responisibility for all work done by either
OWNER' S NAME:
DATE :
MIAlbII SHORES VILLAGE
Paint Color approval and Agreement
ADDRESS: goo /lie 9d J7
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:_
APPROVED:
Building Official Date
�
u AIWA 1-4-1J PHONE( rJ 757 SP37
********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color t•
Walls -- /3q
Fascia 9W_ 8. ill •
Drip Cap/Drip Edge AVM
Soffit 9?/ 674
Roof c/ea ?'�5
Flower Bins
Shutters Q 6/
Awnings Gv /f`t
Chimney /6t
Doors and door jams 9
Garage Doors 97/,
Railings g/6 i
Fences a€,/9
Decorative Metal 4v/
All brick (simulated or regular) 1/f
Stucco Banding /-,/' - /4//
Any other stucco features e /At
Accessory Buildings iv Pi
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. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will be as per the attached
samples.
7
1183J AincjS!IDS
''`_h0
Date
Signature of Owner Date Signature of Contracctor
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
M
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